主动脉缩窄合并心内畸形同期手术治疗的麻醉处理

摘要

Objective To explore the anesthesia management for the surgery for aortic coarctation and intracardiac malformation.Methods A retrospective analysis was conducted on 28 cases of patients with aortic coarctation associated with intracardiac malformation who undergone aortic coarctation and intracardiac malformation surgery in terms of anesthesia, monitoring, circulation management and vital organ protection. ResultsDuring the anaesthetic period, hemodynamic indexes stayed stable, pulmonary artery pressure control were satisfactory, and there was no low cardiac output syndrome. During the surgical period, the average aortic cross-clamp time was (30.1±8.7) min and the average extracorporeal circulation time was (53.1±11.5) min. There was no anesthetic death or serious complication like paraplegia or acute renal failure.Conclusion The anesthesia management in the combined surgical treatment of aortic coarctation and intracardiac malformation is complicated. The maintenance of stable cardiac function and hemodynamic indexes, the regulation of pulmonary artery pressure and the prevention & cure of vital organ dysfunction are important links to the successful anesthesia.%目的：探讨主动脉缩窄合并心内畸形同期手术治疗的麻醉处理方法。方法回顾性分析28例主动脉缩窄合并心内畸形患者同期施行主动脉缩窄及合并的心内畸形矫正术的麻醉、监测、循环管理和重要器官保护的情况。结果麻醉期间血流动力学维持稳定，肺动脉压力控制满意，无1例发生低心排综合征。手术期间平均阻断主动脉时间（30.1±8.7）min，平均体外循环时间（53.1±11.5）min。无麻醉死亡，未发生截瘫、急性肾功能衰竭等严重并发症。结论主动脉缩窄合并心内畸形同期手术治疗的麻醉处理较复杂，维护心功能和血流动力学的稳定、调控肺动脉压力和防治重要器官功能不全是麻醉成功的重要环节。