临床麻醉学温医大心血管手术的麻醉课件.pptVIP

Anesthesia for Cardiovascular Surgery Learning Objectives ? Vocabulary coronary artery bypass graft (CABG) surgery 冠状动脉搭桥手术 myocardial ischemia 心肌缺血 transesophageal echocardiography(TEE) 经食管超声心动图 Intraortic balloon pump(IABP) 主动脉球囊反搏 Vocabulary Rheumatic heart disease 风湿性心脏病 Congenital Heart Disease 先天性心脏病 Total anomalous pulmonary venous return 全肺静脉回流异常 Vocabulary Mitral Stenosis 二尖瓣狭窄 Aortic Stenosis 主动脉瓣狭窄 Pulmonic stenosis 肺动脉狭窄 Mitral valvular regurgitation 二尖瓣反流 Tricuspid regurgitation 三尖瓣反流 Aortic Insufficiency 主动脉瓣关闭不全 Vocabulary atrial septal defect (ASD) 房间隔缺损 Ventricular septal defect (VSD) 室间隔缺损 patent ductus arteriosus (PDA) 动脉导管未闭 Tetralogy of Fallot 法乐（氏）四联症 Pulmonary atresia 肺动脉闭锁 Double-outlet right ventricle 右室双出口 Vocabulary Carotid artery surgery 颈动脉手术 Abdominal aortic aneurysm 腹主动脉瘤 Aortic cross-clamping 主动脉交叉钳夹 Thoracic aortic dissection 胸主动脉壁夹层形成 Thoracic aortic aneurysm 胸主动脉瘤 Tests 1 Atrial septal defect Ventricular septal defect Patent ductus arteriosus Mitral valvular regurgitation Mitral Stenosis Aortic Stenosis Test 2 Abdominal aortic aneurysm Thoracic aortic aneurysm Carotid artery surgery Pulmonary atresia Rheumatic heart disease Congenital heart disease Preanesthetic assessment Anesthetic management Postoperative care 11.1.1 Cardiac evaluation Cardiac evaluation should determine the major anatomic （解剖学的） and physiologic（生理学的） characteristics of the cardiovascular system ; this allows one to predict the likelihood （可能性）of intraoperative ischemia and to determine functional reserve of the heart. Such as Radionuclide imaging（放射性核素成像）, Radionuclide ventriculography（核素心室造影）, Echocardiography（超声心动图）, Cardiac catheterization. 11.1.2 Issues pertinent to cardiac surgical procedures Prior surgery on the thorax, heart, great vessel, lungs Prior admissions for peripheral vascular disease Carotid arterial disease A history of bleeding tendency A history of heparin-induced thrombocytopenia (HIT) Renal insuffi