1例突发血流动力学不稳定的老年钙化性重度主动脉瓣狭窄治疗体会
黄振辉 刘文高 彭晓鹏 袁昊尧 陈启明 邓港浩 曹卫东[摘要] 钙化性主动脉瓣狭窄(calcific aortic stenosis,CAS)当发展为重度时,主动脉瓣置换术是最为有效的干预手段。结合这种病例的具体特点,探讨围术期合并心力衰竭时正性肌力药物的正确使用及合并感染时潜在血管麻痹症综合征的处理和优化容量管理等方面对麻醉诱导可能造成的影响进行经验总结。本研究报道1例突发血流动力学不稳定的老年钙化性重度主动脉瓣狭窄的治疗,并分析心得体会。
[关键词] 主动脉瓣狭窄;脓血症;正性肌力药物;心力衰竭;血管麻痹综合征
[中图分类号] R542.5? ? ? ? ? [文献标识码] C? ? ? ? ? [文章编号] 1673-9701(2022)12-0172-03
[Abstract] Aortic valve replacement is the most effective intervention when calcific aortic stenosis (CAS) is severe.Combined with the specific characteristics of this case, the possible influence of the correct use of positive inotropic drugs in perioperative patients with heart failure and the management of latent vascular paralysis syndrome and optimal volume management in patients with infection on anesthesia induction and its experience were summarized. This study reported the treatment of a case of elderly calcified severe aortic stenosis with sudden hemodynamic instability, and analyzed the experience.
[Key words] Aortic stenosis; Pyemia; Positive inotropic drug; Heart failure; Vascular paralysis syndrome
钙化性主动脉瓣疾病(calcific aortic valvedisease ......
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