高风险心脏病女性临产和分娩时的麻醉:具体病变
- Author
- Katherine W Arendt, MD
Katherine W Arendt, MD
- Associate Professor of Anesthesiology
- Mayo Clinic
- Section Editors
- David L Hepner, MD
David L Hepner, MD
- Section Editor — Obstetric Anesthesia
- Associate Professor of Anaesthesia
- Harvard Medical School
- Heidi M Connolly, MD, FASE
Heidi M Connolly, MD, FASE
- Section Editor — Congenital Heart Disease
- Professor of Medicine
- Mayo Medical School
- Jonathan B Mark, MD
Jonathan B Mark, MD
- Section Editor — Cardiac Anesthesia
- Professor of Anesthesiology
- Duke University Medical Center
- Chief, Anesthesiology Service
- Veterans Affairs Medical Center
- Deputy Editor
- Nancy A Nussmeier, MD, FAHA
Nancy A Nussmeier, MD, FAHA
- Deputy Editor — Anesthesiology
- Department of Anesthesia, Critical Care, and Pain Medicine
- Massachusetts General Hospital
- Translators
- 王古岩, 主任医师,教授
王古岩, 主任医师,教授
- 中国医学科学院阜外医院麻醉中心
引言
高风险心血管疾病妊娠女性的麻醉管理须知如下事宜:
●患者的基线心脏解剖结构与病理生理学
●妊娠、临产和分娩的生理性变化对患者的心脏疾病的影响
●镇痛及麻醉技术对患者心脏疾病的影响
理想的情况下,患者的医疗团队(心脏科医生、产科医生和麻醉科医生)将在产前制定出个体化的管理方案。学科间的交流和准备至关重要,因为围产期的产科并发症和心脏并发症可能需要紧急干预。
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Topic Outline- 引言
- 监测
- 临产和分娩的镇痛与麻醉
- 临产的椎管内镇痛
- 剖宫产的椎管内麻醉
- 剖宫产的全身麻醉
- 主动脉瓣狭窄
- 病理生理学
- 血流动力学目标及管理
- 麻醉技术
- 二尖瓣狭窄
- 病理生理学
- 血流动力学目标及管理
- 麻醉技术
- - 临产的椎管内镇痛
- - 剖宫产的椎管内麻醉
- - 剖宫产的全身麻醉
- 产后的肺水肿风险
- 二尖瓣或主动脉瓣关闭不全
- 病理生理学
- 血流动力学目标及管理
- 麻醉技术
- - 临产的椎管内镇痛
- - 剖宫产的椎管内麻醉
- - 剖宫产的全身麻醉
- 急性二尖瓣或主动脉瓣关闭不全
- 紫绀型先天性心脏病
- 病理生理学
- 血流动力学目标及管理
- 麻醉技术
- - 临产的椎管内镇痛
- - 剖宫产的椎管内麻醉
- - 剖宫产的全身麻醉
- 缺血性心脏病
- 病理生理学
- 血流动力学目标及管理
- 麻醉技术
- - 临产时的椎管内镇痛
- - 剖宫产的椎管内麻醉
- - 剖宫产的全身麻醉
- 扩张型心肌病与心肌病伴子痫前期
- 病理生理学
- 血流动力学目标及管理
- 麻醉技术
- - 临产的椎管内镇痛
- - 剖宫产的椎管内麻醉
- - 剖宫产的全身麻醉
- 心肌病伴子痫前期
- - 临产的椎管内麻醉
- - 剖宫产的椎管内麻醉
- - 剖宫产的全身麻醉
- 肥厚型心肌病
- 病理生理学
- 血流动力学目标及管理
- 麻醉技术
- - 临产的椎管内镇痛
- - 剖宫产的椎管内麻醉
- - 剖宫产的全身麻醉
- 主动脉瘤或主动脉夹层(马方综合征)
- 病理生理学
- - 主动脉瘤
- 血流动力学目标及管理
- 麻醉技术
- - 临产的椎管内麻醉
- - 剖宫产的椎管内麻醉
- - 剖宫产的全身麻醉
- 主动脉夹层
- 总结与推荐
- REFERENCES
GRAPHICS
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