天津医药 ›› 2017, Vol. 45 ›› Issue (6): 632-633.doi: 10.11958/20170233

• 临床研究 • 上一篇    下一篇

远期心脏移植术后腹主动脉瘤支架注入术麻醉体会

张志强,张山△,孟利江   

  1. 石家庄市,河北医科大学第二医院麻醉科(邮编 050000)
  • 收稿日期:2017-02-27 修回日期:2017-04-20 出版日期:2017-06-15 发布日期:2017-07-05
  • 通讯作者: △通讯作者 E-mail:zhang18531135269@126.com E-mail:shanzhang-sam@hotmail.com
  • 作者简介:张志强(1973),男,副教授,硕士,主要从事围术期脏器保护研究

The anesthesia of stent implantation for abdominal aortic aneurysm after long term heart transplantation

ZHANG Zhi-qiang,ZHANG Shan△,MENG Li-jiang   

  1. Department of Anesthesiology, the Second Hospital,Hebei Medical University,Shijiazhuang 050000,China
  • Received:2017-02-27 Revised:2017-04-20 Published:2017-06-15 Online:2017-07-05
  • Contact: △Corresponding Author E-mail:zhang18531135269@126.com E-mail:shanzhang-sam@hotmail.com

摘要: 远期心脏移植术后患者存在不同程度的心脏移植物血管病,冠状动脉造影表现为部分或弥漫性冠状动脉 狭窄,是远期受者主要死亡原因之一。由于移植的心脏无植物神经支配,极少出现典型的心绞痛症状,至病变终末 期才以严重的充血性心力衰竭或心律失常为首发症状。所以不论何种原因接受的心脏移植,移植后特别是长期生 存者,应当按照冠心病处理原则进行诊治。本文总结了 1 例心脏移植患者术后 8 年发现腹主动脉瘤后行腹主动脉 瘤支架注入术的过程,在术前及术中按照冠心病处理原则进行术前准备及围手术期管理,患者安全度过围术期,康 复出院。

关键词: 心脏移植, 主动脉瘤, 腹, 组织支架, 麻醉

Abstract: There are different degrees of cardiac allograft vasculopathy in patients with long term cardiac transplantation. Coronary angiography shows partial or diffuse coronary artery stenosis, which is one of the main causes of death. There are few typical symptoms of angina pectoris because of no autonomic innervation in transplanted heart. The first symptom to the end of the disease is severe congestive heart failure or arrhythmia. So the principles of diagnosis and treatment in long- term survivors should be in accordance with the coronary heart disease treatment. In this paper, we reported a case of anesthesia of a patient underwent stent implantation for abdominal aortic aneurysm after 8 years of cardiac transplantation. The preoperative preparation and perioperative management were performed according to the principle of coronary heart disease. The patient passed through the perioperative period safely.

Key words: heart transplantation, aortic aneurysm, abdominal, tissue scaffolds, anesthesia