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目的:探讨高原地区心脏黏液瘤手术的麻醉管理。方法:本组患者50例,术前均经超声心动图确诊。患者入室后全程监测心电图(ECG),血氧饱和度(SPO_2),有创动脉血压,中心静脉压(CVP),体温,血气分析。转机前监测激活凝血时间(ACT)大于480秒,术中常规应用动脉微栓过滤器。心脏复跳后泵注硝普钠(0.5~1)μg/(kg·min),多巴胺(5~10)μg/(kg·min)维持循环。结果:本组患者麻醉满意,血流动力学平稳,手术顺利,无体肺循环栓塞,术后均痊愈出院。结论:心脏黏液瘤患者的麻醉应力求平稳诱导,保持血流学动力学稳定,术中严密监测ACT,加强心肌保护,心脏复跳后用硝普钠和多巴胺辅助循环等麻醉管理是高原地区心脏黏液瘤手术麻醉成功的关键。
Objective: To investigate the anesthetic management of cardiac myxoma in high altitude area. Methods: 50 patients in this group were confirmed by echocardiography before operation. After the patient entered the room, electrocardiogram (ECG), oxygen saturation (SPO_2), invasive arterial pressure, central venous pressure (CVP), body temperature and blood gas analysis were monitored. Pre-transfer monitoring of coagulation time (ACT) is greater than 480 seconds, intraoperative routine use of arterial micro-thrombus filter. After heart resuscitation, sodium nitroprusside (0.5 ~ 1) μg / (kg · min) and dopamine (5 ~ 10) μg / (kg · min) Results: The patients in this group were satisfied with anesthesia, stable hemodynamics, successful operation, no pulmonary embolism and were cured after operation. CONCLUSIONS: Anesthesia in patients with cardiac myxoma should be induced smoothly and maintain hemodynamic stability. Intraoperative monitoring of ACT should be performed to enhance myocardial protection. Anesthesia management such as nitroprusside and dopamine anesthesia after cardioversion is the heart of plateau area Key to the success of myxoma surgery anesthesia.