器官移植麻醉双语

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1、器官移植麻醉OrganTransplantation湘雅医院麻醉科张海萍1AnesthesiaforKidneyTransplantationKidneysarethemostcommonmajororgantransplanted，thesuccessofkidneytransplantation，whichislargelyduetoadvancesinimmunosuppressivetherapy，hasgreatlyimprovedthequalityoflifeforpatientswithend-stagerenaldisease.2Indica

2、tionsPatientswithend-stagerenaldiseasesanddependentondialysis（透析）foralongtime.3CharacteristicofPathophysiologyChangesofelectrolyteandacid-basebalanceWaterintoxication（水中毒），hyperkalemia（高钾），hyponatremia（低钠），hypernatremia（高钠）andmetabolicacidemia（代酸）.4CardiovascularHypertension（高血压）Ren

3、alischemia，sodiumretentionandabnormalitiesintherenin-agiotensionsystemresultinsystemichypertension.Uremiccardiacdiseasemyocardiosis（心肌炎），pericarditis（心包炎），leftventricularhypertrophy）（左室肥大），coronaryischemia（冠脉缺血），angiosclerosis（血管硬化）.5Potentialcongestiveheartfailure（潜在性充血性心力衰竭）andpul

4、monaryedema（肺水肿）arrhythmia（心律失常）6HematologicBonemarrowsuppression,decreasederythropoietinproduction,decreasederythrocyteproduction,increaseddeformationerythrocyteproductionandincreasedbleedingtendencyAnemia(贫血).Liverdiseasecoagulationfactor，Uremia(尿毒症)andusingofheparincoagulationdis

5、order，bleedingtime.7OtherchangesNausea（恶心），vomit（呕吐），anorexia（厌食），diarrhoea（腹泻），ascites（腹水）andgastricdilatation（胃扩张）.Infection（感染）.Hypoproteinemia（低蛋白血症），hyperglycemia（高血糖症）.8EvaluationandpreparationbeforeanesthesiaPreanestheticevaluationThisassessmentincludesapatienthistory,aphysic

6、alexaminationandanyindicatedlabtests,classifyingthepatientaccordingtotheASAphysicalstatusscalecompletestheassessment.9GeneralconditionPatientsareoftencombinedwithhypoproteinemia,anemia,coagulationdisorderandfluid,electrolyteandacid-basedisturbanceandsoon.ConcurrentdiseasesCardiovasc

7、ular,pulmonary,cerebral,hepaticandotherdiseasesarecommonlycoexisted.Statusofimmunosuppression（免疫抑制）andinfection（感染）.10PreanestheticpreparationCareofdonorkidneyKidneyshouldhavegoodcirculationperfusionbeforebeingseparatedfromdonor,warmischemiatimeandcoldischemiatimeshouldbeminimized,s

8、eparatedkidneyshoul