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晚期卵巢癌伴超高腹腔内压力患者CRS及HIPEC的麻醉管理：1例病例报告

Anesthesia management of CRS and HIPEC in advanced ovarian cancer with ultra-high intra-abdominal pressure: a case report.

作者信息

Chen Suli, Lin Yanjun, Gao Shuncai, Liu Shuo, Yang Zhanmin, Ma Ruiqing, Lu Liangyuan

机构信息

Department of Anesthesiology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.

Department of Myxomatology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.

出版信息

Front Oncol. 2024 Nov 27;14:1449171. doi: 10.3389/fonc.2024.1449171. eCollection 2024.

DOI:10.3389/fonc.2024.1449171
PMID:39664174
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11631864/
Abstract

Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a leading treatment for advanced ovarian cancer, significantly improving overall survival and disease-free survival. This case involves a patient with peritoneal metastasis and ultra-high intra-abdominal pressure (36 mmHg). CRS + HIPEC induces extensive pathological and physiological changes affecting respiratory, circulatory, renal, coagulation, and metabolic systems. Effective perioperative anesthesia management, including the type and volume of fluids administered, is crucial for optimizing patient outcomes. The complexities of anesthesia management in such cases present significant challenges.

摘要

细胞减灭术（CRS）联合腹腔热灌注化疗（HIPEC）是晚期卵巢癌的主要治疗方法，可显著提高总生存率和无病生存率。本病例涉及一名伴有腹膜转移和超高腹腔内压力（36 mmHg）的患者。CRS+HIPEC会引发广泛的病理和生理变化，影响呼吸、循环、肾脏、凝血和代谢系统。有效的围手术期麻醉管理，包括所输注液体的类型和量，对于优化患者预后至关重要。此类病例的麻醉管理复杂性带来了重大挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de3d/11631864/c7954eabba67/fonc-14-1449171-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de3d/11631864/ff009ed763b1/fonc-14-1449171-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de3d/11631864/7b3b1c804c07/fonc-14-1449171-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de3d/11631864/c7954eabba67/fonc-14-1449171-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de3d/11631864/ff009ed763b1/fonc-14-1449171-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de3d/11631864/7b3b1c804c07/fonc-14-1449171-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de3d/11631864/c7954eabba67/fonc-14-1449171-g003.jpg

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本文引用的文献

1
Impact of fluid and haemodynamic management in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy on postoperative outcomes - A systematic review.腹腔热灌注化疗减瘤手术中液体与血流动力学管理对术后结局的影响——一项系统综述
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Temperature management during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.
减瘤手术联合腹腔内热灌注化疗期间的体温管理
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Rapid sequence induction and intubation.快速顺序诱导插管
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Safety, feasibility, and application of intraperitoneal gas-based hyperthermia beyond 43°C in the treatment of peritoneal metastasis: An pilot study.腹腔内高于43°C气基热疗治疗腹膜转移的安全性、可行性及应用：一项初步研究。
Front Oncol. 2022 Oct 11;12:953920. doi: 10.3389/fonc.2022.953920. eCollection 2022.
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High intra-abdominal pressure during hyperthermic intraperitoneal chemotherapy (HIPEC) following cytoreductive surgery (CRS) for peritoneal surface malignancies.腹腔内高压在细胞减灭术后腹腔热灌注化疗（HIPEC）治疗腹膜表面恶性肿瘤中的应用。
Int J Hyperthermia. 2022;39(1):1195-1201. doi: 10.1080/02656736.2022.2121861.
7
Perioperative fluid management and outcomes in adult deceased donor liver transplantation - A systematic review of the literature and expert panel recommendations.成人尸体供肝移植围手术期液体管理与结局——文献系统综述及专家小组建议
Clin Transplant. 2022 Oct;36(10):e14651. doi: 10.1111/ctr.14651.
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Phases of fluid management and the roles of human albumin solution in perioperative and critically ill patients.围术期和危重症患者液体管理的阶段和人血白蛋白溶液的作用。
Curr Med Res Opin. 2020 Dec;36(12):1961-1973. doi: 10.1080/03007995.2020.1840970. Epub 2020 Nov 5.
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Gynecol Oncol. 2020 Sep;158(3):794-802. doi: 10.1016/j.ygyno.2020.06.487. Epub 2020 Jul 2.