中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

肝硬化门静脉高压症患者的麻醉管理策略

王琳 许际平 刘静 马先春 孙文兵

引用本文:
Citation:

肝硬化门静脉高压症患者的麻醉管理策略

DOI: 10.3969/j.issn.1001-5256.2018.01.041
详细信息
  • 中图分类号: R575.2

Anesthetic management strategies for patients with cirrhotic portal hypertension

  • 摘要:

    肝硬化门静脉高压症患者具有多系统器官功能障碍,其麻醉管理有特殊性,涉及麻醉药物代谢障碍、高动力循环、围术期低氧血症、凝血功能障碍、出血、血栓形成和肝性脑病等多方面的综合考量,是麻醉医师工作中的难点。综述了肝硬化门静脉高压症麻醉管理策略,为围手术期优化麻醉管理提供有效参考。

     

  • [1]KIAMANESH D, RUMLEY J, MOITRA VK.Monitoring and managing hepatic disease in anaesthesia[J].Br J Anaesth, 2013, 111 (Suppl 1) :i50-i61.
    [2]STARCZEWSKA MH, MON W, SHIRLEY P.Anaesthesia in patients with liver disease[J].Curr Opin Anaesthesiol, 2017, 30 (3) :392-398.
    [3]TELEM DA, SCHIANO T, GOLDSTONE R, et al.Factors that predict outcome of abdominal operations in patients with advanced cirrhosis[J].Clin Gastroenterol Hepatol, 2010, 8 (5) :451-457.
    [4]LYU YF, HAN XY, GONG XG, et al.Key factors of therapeutic effects for surgery in patients with cirrhotic portal hypertension[J].Eur Rev Med Pharmacol Sci, 2015, 19 (18) :3492-3499.
    [5]LI X.Use of ASA grade in surgical risk estimation for the elderly patients with liver cancer[J].Pract Geriatr, 2015, 29 (9) :755-758. (in Chinese) 李响.美国麻醉医师协会分级在老年肝癌患者外科治疗风险评估中的作用[J].实用老年医学, 2015, 29 (9) :755-758.
    [6]GE PS, RUNYON BA.Treatment of patients with cirrhosis[J].N Engl J Med, 2016, 375 (8) :767-777.
    [7]RAHIMZADEH P, SAFARI S, FAIZ SH, et al.Anesthesia for patients with liver disease[J].Hepat Mon, 2014, 14 (7) :e19881.
    [8]LYU SJ.Anesthetic treatment in surgery for patients with portal hypertension[J].J World Latest Med Inf, 2015, 15 (89) :124-125. (in Chinese) 吕淑娟.门静脉高压症患者手术的麻醉处理分析[J].世界最新医学信息文摘, 2015, 15 (89) :124-125.
    [9]XU Y, LI P, WEI L.Clinical application of general anesthesia combined with epidural anesthesia in thoracic surgery[J].Curr Physician, 2017, 23 (11) :21-23. (in Chinese) 许勇, 李平, 韦玲.全身麻醉联合硬膜外麻醉在胸部手术中的临床应用[J].当代医学, 2017, 23 (11) :21-23.
    [10]KOU PL, HE Y, BAI ZH.Anesthetic effect of general anesthesia combined with epidural anesthesia in gastrectomy[J].Jilin Med J, 2014, 35 (5) :1035-1036. (in Chinese) 寇鹏林, 贺勇, 白治虎.全身麻醉联合硬膜外麻醉用于胃癌根治术麻醉效果分析[J].吉林医学, 2014, 35 (5) :1035-1036.
    [11] HUANG ZJ.Role of general anesthesia combined with epidural anesthesia in analgesic treatment after surgery for gastric carcinoma[J].World Clin Med, 2016, 10 (3) :56. (in Chinese) 黄助军.全身麻醉联合硬膜外麻醉在胃癌术后镇痛中的作用[J].世界临床医学, 2016, 10 (3) :56.
    [12]LUO L.Clinical effect of preanesthetic medication with penehyclidine hydrochloride in cholecystectomy for elderly patients and its influence on liver function[J].Chin Hepatol, 2017, 22 (2) :184-186. (in Chinese) 罗亮.老年患者胆囊切除术使用长托宁麻醉前给药的疗效和对肝功能的影响[J].肝脏, 2017, 22 (2) :184-186.
    [13]SERGEEVA OA.GABAergic transmission in hepatic encephalopathy[J].Arch Biochem Biophys, 2013, 536 (2) :122-130.
    [14]SOLEIMANPOUR H, SAFARI S, SHAHSAVARI NIA K, et al.Opioid drugs in patients with liver disease:a systematic review[J].Hepat Mon, 2016, 16 (4) :e32636.
    [15]DEVLIN JW, ROBERTS RJ.Pharmacology of commonly used analgesics and sedatives in the ICU:benzodiazepines, propofol, and opioids[J].Anesthesiol Clin, 2011, 29 (4) :567-585.
    [16]ABBAS N, MAKKER J, ABBAS H, et al.Perioperative care of patients with liver cirrhosis:a review[J].Health Serv Insights, 2017, 10:1178632917691270.
    [17]MILLER.Miller anesthesiology[M].8th ed.Beijing:Peking University Medical Press, 2016:1230-1238. (in Chinese) 米勒.米勒麻醉学[M].第八版.北京:北京大学医学出版社, 2016:1230-1238.
    [18]BURGER-KLEPP U, KARATOSIC R, THUM M, et al.Transesophageal echocardiography during orthotopic liver transplantation in patients with esophagoastric varices[J].Transplantation, 2012, 94 (2) :192-196.
    [19]SURANI SR, MENDEZ Y, ANJUM H, et al.Pulmonary complications of hepatic diseases[J].World J Gastroenterol, 2016, 22 (26) :6008-6015.
    [20]BERNAL W, AUZINGER G, DHAWAN A, et al.Acute liver failure[J].Lancet, 2010, 376 (9736) :190-210.
    [21]HO HL, HUANG HC.Molecular mechanisms of circulatory dysfunction in cirrhotic portal hypertension[J].J Chin Med Assoc, 2015, 78 (4) :195-203.
    [22]YU WF, WANG TL, GUO XY, et al.Expert consensus on perioperative application ofα1adrenergic receptor agonists (2017 version) [J].J Clin Anesthesiol, 2017, 33 (2) :186-192. (in Chinese) 俞卫锋, 王天龙, 郭向阳, 等.α1肾上腺素能受体激动剂围术期应用专家共识 (2017版) [J].临床麻醉学杂志, 2017, 33 (2) :186-192.
    [23]CHEN HS, XING SR, XU WG, et al.Portopulmonary hypertension in cirrhotic patients:prevalence, clinical features and risk factors[J].Exp Ther Med, 2013, 5 (3) :819-824.
    [24]DAVENPORT A, SHEIKH MF, LAMB E, et al.Acute kidney injury in acute-on-chronic liver failure:where does hepatorenal syndrome fit?[J].Kidney Int, 2017, 92 (5) :1058-1070.
    [25]MELTZER J, BRENTJENS TE.Renal failure in patients with cirrhosis:hepatorenal syndrome and renal support strategies[J].Curr Opin Anaesthesiol, 2010, 23 (2) :139-144.
    [26]KANG SH, LEE YB, LEE JH, et al.Rifaximin treatment is associated with reduced risk of cirrhotic complications and prolonged overall survival in patients experiencing hepatic encephalopathy[J].Aliment Pharmacol Ther, 2017, 46 (9) :845-855.
    [27]DMELLO D, CRUZ-FLORES S, MATUSCHAK GM.Moderate hypothermia with intracranial pressure monitoring as a therapeutic paradigm for the management of acute liver failure:a systematic review[J].Intensive Care Med, 2010, 36 (2) :210-213.
    [28]MUNOZ SJ.Therapeutic hypothermia in acute liver failure:a multicenter retrospective cohort analysis[J].Liver Transpl, 2015, 21 (7) :1007-1008.
  • 加载中
计量
  • 文章访问数:  2005
  • HTML全文浏览量:  98
  • PDF下载量:  409
  • 被引次数: 0
出版历程
  • 出版日期:  2018-01-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回