不同麻醉方法用于肝硬化门脉高压症手术的评估

目的：总结和比较肝硬化门脉高压症手术的不同麻醉选择和处理。方法：采用回顾法，收集10年内的l496例门脉高压症手术病人的资料，对这些病例的术前情况、麻醉选择、麻醉处理及术中输血输液情况加以总结，并从中找出规律。结果：术前肝功能接近正常者，常用麻醉方法和用药对其影响不大。可选择单管法连硬外或选择双管法，若伴有上消化道出血的危重病人急诊手术时，施行硬膜外麻醉别无论在操作上还是术中管理方面都难以维持血流动力学稳定和确保氧供需平衡，不宜首选，选择全身麻醉是安全的。结论：对于肝硬化门脉高压症病人的麻醉选择应服从具体情况，以维持术中循环稳定，保持肝脏灌注充分，对病人肝功能损害最小为原则。连硬外麻醉 全身麻醉的方法有其优越性。

THE EVALNATION OF DIFFERENT ANAESTHETIC METHODS TO THE PATEINTS WITH HEPATOCIRRHOSIS AND PORTAL HYPERTENTION

Objective:To summarize and compare the different anaesthetic methods used to the pateints with hepatocirrhosis and portal hypertontion.Methods:We had collected 1?496 files of the pateins with hepatocirrhosis and portal hypertenfion, to study and compare the preoperafioa conditions , anaesthetic methods , management during anaesthsia, fiuid therapy and blood transplantation during sugery. Results:Common anaesthetic method and drugs have little effect to the patients who have nearly normal liver function. Epkiural anesthesia can be used. But general anethesia is suitabal and safe to the patients who had upper digestive trace hemorrhage. Conclusion:To the pateints with hepatocirrhosis and portal hypertenfion, the choice of anesthesia must depend on the situation of each case , for the aim of stable circulation ,enough blood filling in liver and protect liver function.