活体供肝切除术的麻醉管理

目的 回顾性分析45例活体供肝切除术的麻醉管理和手术经过.方法 回顾45例活体肝移植供肝切除术的麻醉处理过程和手术经过,术中持续监测BP、HR、SpO2、CVP、PETCO2等重要的生理指标.在手术开始、供肝切除前、后30 min三个时点分别采血检测血常规、血生化、肝肾功能、凝血功能和动脉血气.结果 术中血流动力学稳定,所有供体均未发生术中并发症和死亡.肝功能的各项指标在供肝切除过程中发生了剧烈的变化,凝血功能随着手术的进行也有一定程度的恶化,肾功能则未受到明显影响.结论 尽管术中多项生理指标发生明显异常,但活体供肝切除术能够在保持血流动力学稳定、术后无手术并发症的情况下顺利完成.

Anaesthetic management in living donor hepatectomy

Objective The anaesthetic management and perioperative course of forty five living donor hepatectomies(LDHs) were reviewed retrospectively.Methods A retrospective analysis was made about anaesthetic management and perioperative course of 45 patients who underwent elective lobar donor hepatectomy.Some important physiological parameters such as NIBP,HR,SpO2,CVP,and PETCO2 were measured consecutively during operation.Haemoglobin level and serum chemistry studies,liver function tests,renal function tests,coagulation function,and arterial blood gas were measured and analyzed at the beginning of skin incision,30 minutes before and after hepatectomy.Results There was no morbidity or mortality and no periods of intraoperative hypotension or haemodynamic instability in the operation.The remarkable changes in liver function tests and coagulation were seen during operation,but renal function was not significantly affected.Conclusion The data demonstrates that living donor hepatic resection could be well performed without intraoperative hypotension or haemodynamic instability and perioperative anaesthetic or surgical complications.