目的:探讨左房粘液瘤切除术的麻醉处理方法.方法:回顾性分析我院自2002年1月至2012年4月手术治疗左房粘液瘤患者28例.术中采用咪唑安定、芬太尼、依托咪酯、维库溴铵诱导麻醉.咪唑安定、芬太尼、维库溴铵分次静推、丙泊酚持续泵注并小量吸入七氟醚维持麻醉.全部患者在中低温体外循环(CPB)下完成手术,用冷血停搏液行心肌保护.术中监测有创动、静脉压力(IBP、CVP)、心电图(ECG)、心率(HR)、血氧饱和度(SpO2)、呼末二氧化碳浓度(PETCO2)、尿量以及血气分析.观察麻醉手术过程中血流动力学的变化及并发症的发生率.结果:28例患者均在全麻体外循环下顺利完成手术,其中2例患者在诱导过程中出现明显血流动力学改变,通过改变体位后缓解.无心搏骤停、心衰等严重并发症发生.结论:做好的快速充分的术前准备,术中采用对循环影响小的药物,加强各项生理指标的监测,维持麻醉手术过程中血流动力学的平稳,对左房粘液瘤患者安全手术是必需的.%Objective: To explore the anaesthesia dispose of left atrial myoxoma. Methods: Clinical data of 28 patients with left atrial myoxoma who received operation treatment in our center from Jan. 2002 to Apr. 2012 were analyzed retrospectively. Midazo-lam, Fentanyl, Etomidate, Vecuronium Bromide were used in anaesthesia induction. Proplofol and Sevoflurane were used in maintain-ance of anaesthesia. All patients were operated under low temperature extracorporeal circulation. During the operation, IBP, CVP, ECG,HR , SpO2 and PETCO2 , urine volume and blood gas assay were monitored. Results: Operations for all the 28 patients were accomplished successfully under extracorporeal circulation. Obviously change of hemodynamics occurred in two patients and the symptoms relieved after modifying posture of patients. Serious complication such as sudden cardiac arrest and heart failure were not found. Conclusion: The sufficient preoperative preparation,monitoring of physiological index, and maintenance of stable hemodynamic are essential for the safety of operations for left atrial myoxoma.
展开▼
