CAJ | 학술논문

目的:探讨埃博斯坦(Ebstein)畸形患者手术治疗的麻醉处理方法. 方法:对1999-01至2008-05在我院手术治疗的Ebstein畸形患者共48例进行了总结.全部病例采用静吸复合全身麻醉.术中除常规监测外,经食管超声心动图是围术期必要的监测手段.麻醉维持以中、大剂量芬太尼为主,辅以静脉泵人异丙酚和吸入低浓度的异氟醚或七氟醚.术中控制适当容量,使用血管活性药物,调整内环境至稳定,避免肺血管阻力增加,避免心律失常. 结果:全组患者35例治愈,9例好转,4例死亡.出院患者症状均有明显改善,围术期血流动力学基本平稳. 结论:术前正确评估患者病情,选择正确麻醉方式,术中维护心血管功能稳定和维持低状态肺血管阻力,避免心律失常是患者安全渡过围术期的关键.
목적:탐토애박사탄(Ebstein)기형환자수술치료적마취처리방법. 방법:대1999-01지2008-05재아원수술치료적Ebstein기형환자공48례진행료총결.전부병례채용정흡복합전신마취.술중제상규감측외,경식관초성심동도시위술기필요적감측수단.마취유지이중、대제량분태니위주,보이정맥빙인이병분화흡입저농도적이불미혹칠불미.술중공제괄당용량,사용혈관활성약물,조정내배경지은정,피면폐혈관조력증가,피면심률실상. 결과:전조환자35례치유,9례호전,4례사망.출원환자증상균유명현개선,위술기혈류동역학기본평은. 결론:술전정학평고환자병정,선택정학마취방식,술중유호심혈관공능은정화유지저상태폐혈관조력,피면심률실상시환자안전도과위술기적관건.
Objective:To summarize the experience of anesthetic management for surgical repair of Ebstein's Anomaly. Methods: A total of 48 patients with Ebstein' s anomaly from January 1999 to May 2008 who underwent surgical repair in our hospital were retrospectively summarized for their anesthetic management. The patients included 26 male and 22 female,aged from 5 months to 62 years with the body weight from 6 kg to 68 kg. General anesthesia with intubation was applied and maintained with the intravenous propofol and medium to large dose of fentanyl,accompanied by intravenous injection of isoflurane or by low dose inhalation of sevoflurane. Transesophageal echocardiography ( TEE) was performed to monitor anatomic repair. The circulatory problem was prevented by controlling proper blood volume, avoiding increasing pulmonary vascular resistance and arrhythmia, meanwhile keeping the balance of physical circumstance in vivo. Results: There were 35 patients surgically cured,9 surgically improved and 4 patients died. The symptoms were obviously improved in all patients after discharge. Conclusion:Precise preoperative evaluation,perfect surgical therapy,steady homodynamic,vasodilation of pulmonary vascular resistance with normal heart rhythm were the key points for patients' safety of the operation.