肝肾胰联合移植手术的麻醉及围术期管理.pdfVIP

2006 11 31 11 M ed J Chin P LA V o 31 N o 11 N ovemb er 2006 # 1109 # 肝肾胰联合移植手术的麻醉及围术期管理 陈绍洋 聂煌 熊利泽 胡胜 曾毅 王强 朱萧玲 张维 1 , , , , , , , ; ; , , 1 , , 3 , , , ; ; R614 Anesthesia and perioperative management for simultaneous liverkidneypancreas transplantation: a report of one case Chen Shaoyang, Nie H uang, Xiong Lize et al Department of Anesthesio ogy, Xijing Hospita , Fourt h Mi itary Medica Universit y, Xian 710032, China Abstract Objective To eva uate the anesthesia and perioperative treatment for simu taneous iverkidneypancreas transp antation. Methods T he preoperative preparation inc uded improvement of the hepatic function, a eviation of uremia and contro of b ood g ucose eve . Genera anesthesia w as emp oyed and maintained w ith isof urane combined w ith intermittent intravenou s administration of midazo am, fentany and vecuronium. Dopamine and ow dose of epinephrine w ere used to maintain arteria b ood pressure if necessary. T he parameters of b ood coagu ation, the indexes of hepatic and rena function , b ood g ucose and amy ase eve s in b ood and urine w ere surveyed regu ar y. T he treatment w as adjusted according to the resu ts of tests mentioned above. Results T he circu ation w as stab e and b ood gas w as norma in the course of surgery. T he concentration of b ood g ucose w as higher at the end of the o peration than that of preoperation. N or ma hepatic and pancreatic function w as achieved about a w eek after operation, w hi e the rena function show ed no satisf actory improve ment . T he patient w as given hemodia ysis unti the second transp antation of kidney. T hree days ater, the rena function recovered to nor ma . U p to the present , a the g rafted organs show ed good function. Conclusion Appropriate preoperative preparation, optima anesthetic procedure and management, perf ect protection of funct