中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2014, Vol. 36 ›› Issue (3): 336-339.doi: 10.3881/j.issn.1000-503X.2014.03.021

• 综述 • 上一篇    下一篇

累及右心的下腔静脉瘤栓手术的麻醉处理

朱斌1,黄宇光1,苗齐2   

  1. 中国医学科学院 北京协和医学院 北京协和医院 1麻醉科 2心外科,北京 100730
  • 收稿日期:2013-12-09 出版日期:2014-06-28 发布日期:2014-06-28
  • 通讯作者: 朱 斌 电话:010-69152020,电子邮件 zhubin1998@hotmail.com
  • 基金资助:

    北京协和医院2012年中青年转化医学科研基金

Anesthesia Management for Surgical Resection of Inferior Vena Caval Tumor Thrombus Extending into Right Cardiac Cavities

ZHU Bin1,HUANG Yu-guang1,MIAO Qi2   

  1. 1Department of Anesthesiology,
    2Department of Cardiac Surgery,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
  • Received:2013-12-09 Online:2014-06-28 Published:2014-06-28
  • Contact: ZHU Bin Tel:010-69152020,E-mail:zhubin1998@hotmail.com
  • Supported by:

    Supported by the Young and Middle aged Scientific Research Foundation for Translational Medicine(2012), Peking Union Medical College Hospital

摘要:

下腔静脉瘤栓主要来源于静脉内平滑肌瘤病和肝肾肿瘤。瘤体向上蔓延可累及右心、甚至肺动脉,造成严重循环梗阻。体外循环支持下的瘤体摘除术是治疗累及右心的下腔静脉瘤栓的最为有效方法。由于这种累及右心的下腔静脉瘤栓极为罕见,文献报道也多局限于手术处理的个例介绍,目前尚无临床研究或者文献综述来讨论这种累及右心的下腔静脉瘤栓手术的麻醉处理,即便是有关麻醉处理的个案报道也极为罕见。本文将在简述这类疾病的行为特点和手术方式的基础上,结合笔者在这类手术上的初步经验,探讨如何对这类手术实施麻醉和术中管理。

关键词: 下腔静脉瘤栓, 心脏占位, 麻醉, 经食管超声心动图

Abstract:

Inferior vena caval(IVC)tumor thrombus,majorly originated from intravenous leiomyomatosis(IVL)and renal or hepatic carcinoma,can extend into right cardiac cavities. Complete tumor resection,supported by cardiopulmonary bypass(CPB),has been proved to be the most effective treatment but also to be dramatically challenging. Randomized clinical trials of the surgical treatment for IVC tumor with cardiac extension are very limited due to the disease rarity,whereas publications on IVC tumor surgery are predominately confined to case report. So far,no clinical research or review,focused on intraoperative anesthesia management for surgical resection of IVC tumor with cardiac extension,has been identified;even anesthesia-targeted case report can not be found. In this article,we briefly introduce the disease characteristic and related surgical procedure and offer some suggestions upon the anesthesia management based on our own clinical experiences.

Key words: inferior vena caval tumor thrombus, cardiac mass, anesthesia, transesophageal echocardiography

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