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中国肿瘤心脏病患者新辅助化疗后麻醉管理专家共识(2021版)
引用本文:中国抗癌协会肿瘤麻醉与镇痛专业委员会. 中国肿瘤心脏病患者新辅助化疗后麻醉管理专家共识(2021版)[J]. 中国肿瘤临床, 2022, 49(15): 757-763. DOI: 10.12354/j.issn.1000-8179.2022.20211837
作者姓名:中国抗癌协会肿瘤麻醉与镇痛专业委员会
作者单位:
摘    要:新辅助化疗是在应用局部治疗方法(手术或放疗)前,为使肿块缩小、尽早杀灭肿瘤细胞所实施的全身化疗。但新辅助化疗药物可以对心脏产生不同程度的损伤,主要表现为心肌缺血、心律失常、动脉高压、心肌功能障碍,甚至心力衰竭,现已成为后续肿瘤手术围术期重要的危险因素,可能会影响手术进行以及患者的生命安全。麻醉医生在围术期对肿瘤心脏病患者进行相关的评估、积极的预防及处理尤为重要。因此,中国抗癌协会肿瘤麻醉与镇痛专业委员会组织专家制定《中国肿瘤心脏病患者新辅助化疗后麻醉管理专家共识(2021版)》,从麻醉方法选择、围术期心脏功能保护等方面,总结临床实践经验,期望可以为中国麻醉同道提供工作指引。 

关 键 词:专家共识   新辅助化疗   肿瘤心脏病患者   麻醉管理
收稿时间:2021-12-06

Consensus on anesthetic management of patients with cancer having heart disease after neoadjuvant chemotherapy in China (2021 version)
Abstract:Neoadjuvant chemotherapy (NAC) refers to systemic chemotherapy administered before surgery or radiotherapy to reduce tumor size, kill cancer cells early, and facilitate subsequent treatments. However, NAC drugs can cause different degrees of damage to the heart, which mainly manifest as myocardial ischemia, arrhythmia, arterial hypertension, myocardial dysfunction, and even heart failure. NAC-induced cardiotoxicity has become an important risk factor in the perioperative period of cancer surgery, and it may affect surgical success and patient safety. Therefore, it is particularly important for anesthesiologists to perform relevant evaluations to actively prevent and treat patients with cancer having heart disease in the perioperative period. Therefore, we organized experts to formulate anesthesia management guidelines after NAC for patients with cancer having heart disease in China (2021 version). We also summarized clinical practice experience in terms of anesthesia selection and perioperative cardiac function protection to guide anesthesiologists in China. 
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