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目的 总结儿童亲属活体肝移植的麻醉处理。方法 回顾 11例肝豆状核变性患儿行亲属活体肝移植手术的麻醉处理过程 ,对一些重要生理指标如血压、心率、中心静脉压、体温、激活凝血酶原时间、血糖、血钾和血浆乳酸浓度进行分析。结果 术中 ,尤其是在无肝早期及新肝早期 ,血液动力学波动较大 ,体温在无肝后期及新肝期有不同程度下降 ,凝血功能随着手术的进行有一定程度的恶化 ,血浆乳酸水平在手术后期明显增高。 11例患儿均健康生存 ,其中 1例是于术后因肝动脉血栓形成而行再次异体肝移植术取得成功。结论 儿童亲属活体肝移植术中多项生理指标发生明显变化 ,加强各生理指标的监测、及时纠正循环和代谢紊乱是保证手术成功的关键
Objective To summarize the anesthetic management of living relatives living in children. Methods A retrospective review of 11 cases of hepatolenticular degeneration in children undergoing living donor liver transplantation anesthesia treatment process, for some important physiological indicators such as blood pressure, heart rate, central venous pressure, body temperature, activation of prothrombin time, blood glucose, serum potassium and plasma Lactic acid concentrations were analyzed. Results During the operation, especially in the early stage of liver failure and early stage of neohepatic hemodynamic fluctuation, body temperature decreased in different stages of nonhepatic and neohepatic stages, the coagulation function deteriorated to a certain degree with the operation. Plasma Lactic acid levels increased significantly after surgery. All 11 children survived well, and 1 of them had success after allogeneic liver transplantation due to hepatic arterial thrombosis. Conclusion There are significant changes in many physiological indexes in living relatives of children and relatives. It is necessary to strengthen the monitoring of various physiological indexes and correct the circulation and metabolic disorders in time to ensure the success of the operation