CAJ | 학술논문

目的：分析非体外循环冠状动脉搭桥术（OPCAB）中血流动力学的变化及麻醉处理特点。方法：回顾分析50例冠心病患者择期行OPCAB，均采用咪唑安定、芬太尼、依托咪酯和罗库溴铵诱导，芬太尼、维库溴铵复合七氟醚静吸复合麻醉。术中根据血流动力学变化调整体位和运用血管活性药物。结果：全组病例均成功完成手术，术中生命体征平稳，1例在ICU再次发生急性心肌梗死，经过积极抢救痊愈出院，其余无并发症顺利康复。结论：OPCAB手术时合理运用麻醉药物和血管活性药物，合理运用体位的变化，维持血流动力学的稳定与心肌的氧供需平衡，对于保证手术的顺利进行和患者的安全至关重要。
목적：분석비체외순배관상동맥탑교술（OPCAB）중혈류동역학적변화급마취처리특점。방법：회고분석50례관심병환자택기행OPCAB，균채용미서안정、분태니、의탁미지화라고추안유도，분태니、유고추안복합칠불미정흡복합마취。술중근거혈류동역학변화조정체위화운용혈관활성약물。결과：전조병례균성공완성수술，술중생명체정평은，1례재ICU재차발생급성심기경사，경과적겁창구전유출원，기여무병발증순리강복。결론：OPCAB수술시합리운용마취약물화혈관활성약물，합리운용체위적변화，유지혈류동역학적은정여심기적양공수평형，대우보증수술적순리진행화환자적안전지관중요。
Objective:To analyze the hemodynamic changes and characteristics of anesthesia in off-pump coronary artery bypass(OPCAB). Method:The clinical data of 50 patients with coronary heart disease were retrospectively analyzed,and all patients chose to undergo OPCAB,and all patients received induction with midazolam,fentanyl,and rocuronium bromide,and all patients received intravenous inhalational anesthesia with fentanyl,vecuronium bromide,and sevoflurane. According to intraoperative hemodynamic changes the position was adjusted,and vasoactive drugs were used. Result:All the patients successfully completed surgery,and intraoperative vital signs of patients were stable,and 1 case happened acute myocardial infarction again in ICU,and this patient recovered through active rescue,and the rest of patients didn’t have complication and recovered smoothly. Conclusion:Some measures are very important to ensure the smooth progress of the operation and the safety of patients,including using narcotic drugs and vascular active drugs in OPCAB reasonably,and using the change of position rationally,and maintaining stable hemodynamics and the supply and demand of myocardial oxygen in balance.