摘要
Abstract
Objective:To explore the characteristics of hemodynamics at different phases in orthotopic liver transplantation and anesthetic management. Methods:During the periods from January 2011 to June 2012, thirty-two patients with the chronic end-stage liver disease underwent orthotopic liver transplantation were enrolled in our hospital. All patients were anesthetized under combined intravenous-inhalational anesthesia.The hemodynamic parameters including cardiac output (CO), cardiac index (CI), central venous pressure (CVP) and mean systemic arterial pressure (MAP) were monitored. The artery blood gas parameters were also measured. Results: Compared with those parameters before operation, CO, CI, CVP and MAP decreased significantly at anhepatic stage (P<0.01), but CVP increased while CO, CI and MAP decreased significantly at the early phase of neohepatic stage (P<0.01). The blood gas analysis results indicated that serum pH value decreased slightly. Serum potassium and calcium decreased and base excess and lactate increased at later phase of anhepatic stage. With this correspondence, serum pH value decreased apparently. Serum potassium, base excess and lactate increased further and serum calcium decreased further at neohepatic stage (P<0.01). After comprehensive treatment, electrolyte disturbance and acid-base imbalance were rectified at the end of operation.Conclusion:Hemodynamics changes occurred at later phase of anhepatic stage and early phase of neohepatic stage. Different anesthetic managements were used at hepatectomy, anhepatic and neohepatic stage, electrolyte disturbance and acid-base imbalance should be rectified timely. The comprehensive anesthetic management protects the steady hemodynamics in orthotopic liver transplantation.关键词
肝移植/麻醉/血流动力学/内环境Key words
Liver transplantatiom/Anesthesia/Hemodynamic分类
医药卫生
