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[腹主动脉手术的麻醉管理]

[Management of anesthesia for surgery of the abdominal aorta].

作者信息

Bonnet F, De Hys C, Vodinh J, Morin Y, Becquemin J P, Melliere D, Debras C

出版信息

J Chir (Paris). 1984 May;121(5):365-9.

PMID:6470080
Abstract

Anesthesia and post operative care of patients requiring abdominal aorta surgery are frequently complicated because of associated ischemic cardiopathy or respiratory insufficiency. Pre operative evaluation indicates the optimal peri-operative strategy and the need to appropriate peri-operative monitoring. This applies to patients with a previous history of myocardial infarction or with a poorly or not controlled cardiac insufficiency. The use of Swan-Ganz catheters allows monitoring of the hemo-dynamic parameters during operation, especially at the moment of clamping or unclamping of the aorta. Vasodilators and optimal volume loading allow myocardial adaptation and reduce the incidence of myocardial infarction, the main cause of peri-operative death. To perform these operations in the best conditions requires a close medicosurgical cooperation in specialized teams.

摘要

由于伴有缺血性心脏病或呼吸功能不全,需要进行腹主动脉手术的患者的麻醉和术后护理常常较为复杂。术前评估可确定最佳的围手术期策略以及进行适当围手术期监测的必要性。这适用于有心肌梗死病史或心脏功能不全控制不佳或未得到控制的患者。使用 Swan-Ganz 导管可在手术期间,尤其是在主动脉夹闭或松开时监测血流动力学参数。血管扩张剂和最佳的容量负荷可使心肌适应并降低心肌梗死的发生率,而心肌梗死是围手术期死亡的主要原因。要在最佳条件下进行这些手术,需要专业团队中内科和外科的密切合作。

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