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[糖原贮积病患者肝切除术的麻醉]

[Anesthesia for hepatectomy in a patient with glycogen storage disease].

作者信息

Ogawa M, Shimokohjin T, Seto T, Kaminoh Y, Sakai T, Kishi Y, Yoshikawa K

机构信息

Department of Anesthesiology, Center for Adult Diseases, Osaka.

出版信息

Masui. 1995 Dec;44(12):1703-6.

PMID:8583672
Abstract

We successfully anesthetized a 19-year-old female with type I glycogen storage disease for hepatectomy. She had hypoglycemia and severe metabolic acidosis before surgery. General anesthesia was performed with epidural anesthesia. We used acetated Ringer solution mainly as intraoperative fluids instead of lactated Ringer solution and controlled administration of glucose determining blood glucose. The patient's plasma lactate levels, pyruvate and base excess during and after operation, were unchanged compared with those before operation. Administration of sodium bicarbonate was not necessary. In the case of metabolic acidosis due to accumulation of lactate as in glycogen storage diseases, it was useful to use acetated Ringer solution for fluid therapy.

摘要

我们成功地为一名患有 I 型糖原贮积病的 19 岁女性实施了肝切除术麻醉。术前她存在低血糖和严重代谢性酸中毒。采用硬膜外麻醉进行全身麻醉。术中我们主要使用醋酸林格液而非乳酸林格液作为术中液体,并根据血糖情况控制葡萄糖的输注。患者手术期间及术后的血浆乳酸水平、丙酮酸和碱剩余与术前相比无变化。无需给予碳酸氢钠。对于像糖原贮积病中因乳酸堆积导致的代谢性酸中毒病例,使用醋酸林格液进行液体治疗是有效的。

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