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非体外循环冠状动脉旁路移植术的麻醉管理
引用本文:袁丽丽,周文,文晓兵,徐德朋.非体外循环冠状动脉旁路移植术的麻醉管理[J].临床军医杂志,2012,40(5):1077-1079.
作者姓名:袁丽丽  周文  文晓兵  徐德朋
作者单位:解放军第97医院麻醉科,江苏徐州,221004
摘    要:目的探讨非体外循环下冠状动脉旁路移植术病人的麻醉管理。方法择期非体外循环下冠状动脉旁路移植术病人20例,采用静吸复合全麻。硝酸甘油、艾司洛尔、去氧肾上腺素、多巴胺等用于调控血流动力学指标。观察术后患者血中心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)含量的变化。结果所有患者均顺利完成麻醉和手术,无麻醉并发症,预后良好。术后各时间点血中cTnI和CK-MB含量与术前比均有一定程度升高。结论非体外循环下冠状动脉旁路移植术心肌损伤轻,麻醉管理的关键是维持血流动力学平稳和心肌氧供与氧耗的平衡。

关 键 词:非体外循环  冠状动脉旁路移植术  麻醉管理

Anesthetic management of patients undergoing off-pump coronary artery bypass grafting
Yuan Li-li , Zhou Wen , Wen Xiao-bing , Xu De-peng.Anesthetic management of patients undergoing off-pump coronary artery bypass grafting[J].Clinical Journal of Medical Officer,2012,40(5):1077-1079.
Authors:Yuan Li-li  Zhou Wen  Wen Xiao-bing  Xu De-peng
Institution:(Department of Anesthesia,PLA No.97 Hospital,Xuzhou Jiangsu 221004,China)
Abstract:Objective To investigate the anesthetic management of patients undergoing off-pump coronary artery bypass grafting(OPCABG).Methods Twenty patients underwent OPCABG were anesthetized.Nitroglycerin,Esmolol,Phenylephrine and Dopamine were used to control patients’ hemodynamics.The changes of cTnI and CK-MB were analyzed in serum after operation.Results ALL patients had good recovery and prognosis without any anesthesia complications.The value of cTnI and CK-MB were increased significantly after operation.Conclusion OPCABG has minimal myocardial injury.The key of perioperative management of patients undergoing OPCABG depends on the maintenance of hemodynamics stability and the equilibrium between myocardial oxygenic supply and oxygenic consuming.
Keywords:off-pump  coronary artery bypass grafting  anesthesia management
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