节点文献

肺动脉高压的围术期管理进展

Perioperative management progress of pulmonary hypertension

  • 推荐 CAJ下载
  • PDF下载
  • 不支持迅雷等下载工具,请取消加速工具后下载。

【作者】 冉菊红王锷彭勇刚

【Author】 RAN Juhong;WANG E;PENG Yonggang;Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Zhengzhou University;

【通讯作者】 彭勇刚;

【机构】 郑州大学第一附属医院麻醉与围术期医学部中南大学湘雅医院麻醉手术部美国弗罗里达大学医学院麻醉科

【摘要】 肺动脉高压(PH)是指由多种病因和不同发病机制所致的静息状态下肺动脉平均压≥25 mmHg(经右心导管测定)的病理状态。任何引起左心房压力(LAP)升高、心输出量(CO)和肺血管阻力(RVR)增加的因素均可导致PH。PH患病率约为1%,与围术期发病率和死亡率相关。PH患者术前风险评估决定于PH分类、PH功能分级和运动耐量、右心功能状态、合并症及手术风险等诸多因素。右心衰竭(RNF)和PH密切相关,PH患者的围术期管理需要通过改善右心室功能和降低肺血管阻力来优化右心室-肺动脉耦联。本文就PH的定义、分类、病理机制及围术期麻醉管理等方面的研究进展予以综述,为PH患者围术期管理提供参考。

【Abstract】 Pulmonary hypertension(PH) is a pathology defined as mean pulmonary arterial pressure(mPAP) ≥ 25 mmHg measured by right heart catheterization at rest. It was caused by multiple etiologies and different pathogenesis. Any factor that result in an increase in left atrial pressure(LAP), cardiac output(CO) or pulmonary vascular resistance(PVR) can lead to PH. PH affects approximately 1% of the global population and is associated with significant perioperative morbidity and mortality. Preoperatively, patients with PH should be appropriately risk stratified based on the type of PH, functional class, exercise capacity, right ventricular dysfunction, comorbidities and the risk of surgery. Right ventricular failure(RVF) closely associated with PH. Perioperative management of patients with PH requires optimizing ventricular-to-pulmonary artery coupling by improving right ventricular function and lowering pulmonary vascular resistance. This article reviews the research progress of definition, classification, pathological mechanism to provide strategic approaches for perioperative management of PH by a multidisciplinary team.

  • 【文献出处】 临床麻醉学杂志 ,Journal of Clinical Anesthesiology , 编辑部邮箱 ,2022年06期
  • 【分类号】R544.1
  • 【下载频次】203
节点文献中: 

本文链接的文献网络图示:

本文的引文网络