摘要
目的:探讨原位肝移植术的麻醉管理。方法:本组病人均采用全身麻醉,术中加强监测血流动力学、血气、血生化、凝血功能、血糖、体温、尿量。根据肝移植的无肝前期、无肝期、新肝期的特点给予相应的麻醉处理。结果:无肝期及新肝初期血流动力学波动较大,各期无严重的酸碱紊乱,电解质主要表现为低钙、凝血功能有一定紊乱,术中体温变化不明显,无肝期血糖升高,新肝期血糖逐渐下降。结论:肝移植麻醉中应维持血流动力学稳定,及时纠正水电解质、酸碱平衡的紊乱,加强血气、生化及凝血功能的检测与调控是手术麻醉成功的关键。
Objective：To investigate the perioperative changes and anesthetic management for patients under orthoptopic liver transplantation. Methods： General anesthesia Was conducted. Hemodynamics、blood gas、blood biochemistry、 coagulation function、 blood glucose、 body temperature、 urinary output were monitored duringthe operation. According to the characteristics of per-anhepatic phase, anhepatic phase and neohepatic phases. Corresponding anesthetic management measures were supplied. Results： Hemodynamics changes may occur greatly during anhepatic and early neohepaticphase. No marked acid - base disturbance occurred during orthotopic liver trabsplabtation. The main electrolytic change during perioperative phase was hypocalcemia. Disturbance of coagn- lation function to a certain degree occurred. The blood glucose level was higher than normal during pre - anhepatic phase, and gradually decreased during the neohepatic phase. There was not an marked change in body temperature. Conclusion： Attention should be paid to the anesthetic management and monctoring during different phase of orthotopic liver transplantation. Maintaining hemodynamics stability, correcting fluid electrolyte and acid - base disturbance in time, reinforcing the monitoring and adjustment of blood gas、biochemical alterations and coagulation function are the keys to successful operation.
出处
《内蒙古医学杂志》
2007年第5期547-549,共3页
Inner Mongolia Medical Journal
关键词
原位肝移植
麻醉
管理
Orthotopie liver transplantation
Anesthesia
Management
作者简介
丁翠霞（1966-），女，内蒙古扎兰屯市人，医学学士，副主任医师。
