腹主动脉瘤腔内隔绝术与传统开腹手术麻醉管理比较.docVIP

腹主动脉瘤腔内隔绝术与传统开腹手术麻醉管理比较 夏氢1 陈伟1( 李卫1 蒋岚杉2 崔驰2 （1绵阳市中心医院麻醉科，2绵阳市中心医院血管外科，四川绵阳 621000） 【摘要】 目的 探讨肾下型腹主动脉瘤行覆膜支架腔内隔绝术与传统开腹人工血管置换术的麻醉管理特点。方法 对我院23例肾下型腹主动脉瘤患者采用腔内隔绝术和传统开腹手术治疗的麻醉管理进行回顾性分析。比较两组患者麻醉时间、手术时间、出血量、输血量、术中严重低血压次数 、ICU停留时间、术后住院时间及围术期严重并发症发生情况。结果 腔内组麻醉时间、手术时间、ICU停留时间及术后住院时间均短于开腹组（P0.01），术中出血量及输血量明显少于开腹组（P0.01），术中严重低血压次数及术后严重并发症的例数少于开腹组（P0.01）。结论 两类手术方式麻醉管理各有其特点，保持麻醉血流动力学R614.2 【文献标识码】 A Anesthesia for endovascular stent-graft implantation or artificial vessel replacement in abdominal aortic aneurysm. XIA Qing, CHEN Wei, LI Wei, et al. Department of Anesthesiology, Mianyang Center Hospital, Mianyang, Sichuan 621000, China [Abstract] Objective To approach the anesthetic management of abdominal aortic aneurysm by endovascular stent-graft implantation or artificial vessel replacement. Methods　Twenty- anesthesia cases of abdominal aortic aneurysm were investigated by retrospective analysis, undergone endovascular stent-graft implantation or artificial vessel replacement. The anesthesia time, operation time, bleeding capacity, blood-transfusion capacity, serious hypotension frequency, residence time in ICU, length of stay after operation and critical complication in two groups were observed and compared. Results The anesthesia time, operation time, residence time in ICU and length of stay after operation in endovascular stent-graft implantation group were markedly shorter than that in artificial vessel replacement group (P0.05). The bleeding capacity and blood-transfusion capacity were less in the former (P0.05). The serious hypotension and critical complication happened more in the latter (P0.05). Conclusion Steady anesthesia and hemodynamics is the emphasis of anesthetic management, and the key point to ensure patients safety. [Key words] abdominal aortic aneurysm; anesthetic management; interventional therapy 我院自2004年共收治肾下型腹主动脉瘤23例，实施覆膜支架腔内隔绝术或开腹人工血管置换术，现对两类手术麻醉管理临床资料进行回顾性分析，报告如下。 1 资料与方法 1.1 一般资料 23例肾下型腹主动脉瘤(腔内组)9例，传统开腹行人工血管置换术(开腹组)14例。两组一般资料见表1。 表1 一般资料 腔内组（9例）