摘要
目的总结根治性肾切除术及腔静脉癌栓清除术的麻醉要点。方法回顾性分析我院14例行根治性肾切除术及腔静脉癌栓清除术患者的临床资料,观察患者的手术情况。结果 14例患者手术均成功,手术时间为4.0~10.6 h,平均(7.6±1.8)h;术中出血量为400~11 000 m L,平均(3 067±2 524)m L;输血量为400~9 200 m L,平均(2 939±2 129)m L;手术中未发生癌栓脱落栓塞;术中并发症主要有低血压、低温、代谢性酸中毒、低血钙、高血钾、凝血功能障碍等。结论术前充分了解癌栓分级,选择适当的麻醉方式和麻醉药物,维持循环稳定,预防和及早发现癌栓脱落,积极对症治疗相关并发症是根治性肾切除术及腔静脉癌栓清除术麻醉的关键。
Objective To summarize the main points of anesthesia in radical nephrectomy and thrombectomy of vena cava tumor. Methods The clinical data of 14 cases of patients with radical nephrectomy and thrombectomy of vena ca va tumor in our hospital was retrospectively analyzed. The patients＇ surgery situations were observed. Results The surgeries of all patients were successful, no tumor thrombus embolization occurred during surgery. The operation time ranged from 4.0 to 10.6 h, median time was（7.6±1.8） h. The blood loss ranged from 400 to 11 000 m L, median amount was（3 067±2 524） m L.The blood transfusion ranged from 400 to 9 200 m L, median amount was（2 939 ±2 129） m L. The main intraoperative complications were hypotension, hypothermia, metabolic acidosis, hypocalcemia, hyperkalemia, coagulation disorders and so on. Conclusion The key of anesthesia in radical nephrectomy and thrombectomy of vena cava tumor is fully understanding the grade of tumor thrombus, choosing appropriate anesthesia methods and anesthetics, maintaining the stability of cycle,preventing and early detection of cancer embolus off, and actively treating complications.
出处
《临床医学研究与实践》
2017年第33期67-68,共2页
Clinical Research and Practice
关键词
肾癌
腔静脉癌栓
肾切除术
kidney cancer
thrombectomy of vena cava tumor
nephrectomy
