[1]李丽芳,许燕,舒仕瑜.485例胆道闭锁行Kasai手术患儿的麻醉分析[J].临床小儿外科杂志,2019,18(10):864-867,873.[doi:10.3969/j.issn.1671-6353.2019.10.013]
　Li Lifang,Xu Yan,Shu Shiyu.Anesthetic analysis of 485 patients with biliary atresia during Kasai surgery[J].Journal of Clinical Pediatric Surgery,2019,18(10):864-867,873.[doi:10.3969/j.issn.1671-6353.2019.10.013]
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485例胆道闭锁行Kasai手术患儿的麻醉分析

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第18卷 期数: 2019年10期 页码: 864-867,873 栏目: 论著 出版日期: 2019-10-28
Title:
Anesthetic analysis of 485 patients with biliary atresia during Kasai surgery
作者:
李丽芳1;  许燕2;  舒仕瑜3
1. 大连市儿童医院麻醉科(辽宁省大连市, 116012);
2. 重庆医科大学附属儿童医院麻醉科(重庆市, 400014);
3. 复旦大学附属儿科医院麻醉科(上海市, 201102)
Author(s):
Li Lifang1;  Xu Yan2;  Shu Shiyu3
1. Department of Anesthesiology, Dalian Children’s Hospital, Dalian 116012, China;
2. Department of Anesthesiology, Affiliated Children’s Hospital, Chongqing Medical University, Chongqing 400014, China;
3. Department of Anesthesiology, Children’s Ho
关键词:
胆道闭锁/外科学; 麻醉; 儿童
Keywords:
Biliary Atresia/SU; Anesthsia; Child
分类号:
R657.4+4;R614
DOI:
10.3969/j.issn.1671-6353.2019.10.013
摘要:
目的 探讨胆道闭锁行Kasai手术患儿的麻醉方法和围术期相关问题。方法 回顾性分析复旦大学附属儿科医院2016年2月至2017年2月胆道闭锁行Kasai手术患儿的术前一般情况、麻醉方法、术中麻醉管理、围术期麻醉相关并发症。结果 485例患儿中除1例因声门下狭窄取消手术外，其余484例手术顺利，平均手术时间为100 min，无一例麻醉死亡。484例完成手术的患儿中有2例发生插管困难，但最终插管成功顺利完成手术；203例（41.9%）术中使用血管活性药物（多巴胺或去甲肾上腺素）维持血压稳定。32例（6.7%）术中输入浓缩红细胞；252例（52.1%）发生术中低体温；所有患儿术后10~20 min拔除气管导管；8例（1.6%）发生苏醒延迟。结论 术前麻醉诱导注意保温，防止体温下降，控制液体输注，并以白蛋白为主，防止术中低血压，麻醉维持以吸入为主，有利于术后快速苏醒。
Abstract:
Objective To explore the anesthetic methods and perioperative problems of children with biliary atresia undergoing Kasai operation.Methods Retrospective analysis was conducted for general preoperative profiles,anesthetic methods,intraoperative anesthetic management and perioperative anesthesia related complications from February 2016 to February 2017.Results Except for one case of canceling operation due to subglottic stenosis,the average operative duration was 100 min.All procedures were smooth without any anesthetic mortality.Only two cases experienced a difficulty of tracheal intubation.Among them,41.9% maintained stable blood pressure with vasoactive drugs (dopamine or norepinephrine) and 6.7% were infused intraoperatively with concentrated red blood cells.Hypothermia occurred in 52.1% of them.Tracheal catheter was removed at 10-20 min post-operation.And 1.6% of them had delayed recovery.Conclusion Attention should be paid to maintaining warmth during induction,preventing temperature dropping and controlling fluid infusion.Albumin is a best choice.Also preventing intraoperative hypotension and maintaining inhalation during anesthesia may facilitate postoperative rapid recovery.

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备注/Memo

收稿日期:2018-05-12。
基金项目:国家自然科学基金资助（编号：81200053）；重庆市科委课题（编号：cstc2015jcyjA10095）
通讯作者:舒仕瑜,Email:Shushiyu@hotmail.com

更新日期/Last Update: 1900-01-01