Pierrot M, Blaise M, Pourriat J L, Rathat C, Cupa M
Anesth Analg (Paris). 1981;38(11-12):697-702.
The authors report the cases of two cirrhotic patients without cardiac failure who underwent peritoneo-venous bypass (Leveen valve). On the two cases an acute pulmonary oedema (APE) serious but not fatal was noted at the 36e hour. This one was associated with a rise of cardiac output and a moderate rise of the pulmonary wedge pressure (15-18 mm Hg). The administration of thiamine did not correct these perturbations but small doses of furosemide corrected the APE. Despite the low frequency of the cases of APE after Leveen bypass and their mechanism not definitevely known, the authors recommend in pre-, per- and post-operative period the monitoring of cardiac function with a right catheterism.
作者报告了两例无心力衰竭的肝硬化患者接受腹腔静脉分流术(Leveen瓣)的病例。在这两例患者中,术后36小时出现了严重但非致命性的急性肺水肿(APE)。APE伴有心输出量增加和肺楔压适度升高(15 - 18 mmHg)。给予硫胺素未能纠正这些紊乱,但小剂量呋塞米纠正了APE。尽管Leveen分流术后APE病例的发生率较低且其机制尚不完全清楚,但作者建议在术前、术中和术后通过右心导管插入术监测心功能。