文章摘要
主动脉瓣狭窄患者行非心脏手术的围术期麻醉管理进展
Perioperative anesthesia management progress on aortic stenosis patients undergoing non-cardiac surgery
  
DOI:10.12089/jca.2023.12.017
中文关键词: 主动脉瓣狭窄  非心脏手术  围术期  麻醉管理  术后加速康复
英文关键词: Aortic stenosis  Non-cardiac surgery  Perioperation  Anesthesia management  Enhanced recovery after surgery
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作者单位E-mail
潘四磊 450007,郑州大学附属郑州中心医院麻醉与围术期医学科  
储勤军 450007,郑州大学附属郑州中心医院麻醉与围术期医学科 jimmynetchu@163.com 
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中文摘要:
      主动脉瓣狭窄是一种主要由风湿热后遗症、先天性主动脉瓣结构异常、老年性主动脉瓣钙化等病因所致的一种瓣膜性心脏病(VHD),钙化性主动脉瓣狭窄是其主要形式。超声心动图是目前国际上评估和诊断主动脉瓣狭窄最常用的方法,成人正常主动脉瓣口面积(AVA)≥3.0 cm2,当AVA减小至正常的1/3或更多时才会阻塞主动脉瓣前向血流,大多数轻中度和一部分重度主动脉瓣狭窄患者在日常活动时没有临床症状。主动脉瓣狭窄的流行病学在地区、年龄、性别和种族等方面差异较大。主动脉瓣狭窄增加了非心脏手术围术期心血管并发症的风险,其风险的高低取决于VHD严重程度和非心脏手术类型,而未经治疗的重度主动脉瓣狭窄围术期死亡率较高。本文对主动脉瓣狭窄诊断、分级、分类、病理机制、治疗及非心脏手术围术期麻醉管理等方面的进展予以综述。
英文摘要:
      Aortic stenosis is a valvular heart disease (VHD) mainly caused by rheumatic fever sequelae, congenital aortic valve structural abnormalities, senile aortic valve calcification, and so on, among which calcific aortic stenosis is the chief form of aortic stenosis. Echocardiography is often used technique to evaluate and diagnose aortic stenosis in the world, the normal adults aortic valve area (AVA)≥ 3.0 cm2, when AVA decreases to 1/3 or more of the normal, the aortic valve forward flow will be blocked, most mild to moderate and some severe aortic stenosis patients have no clinical symptoms during daily activities. The epidemiology of aortic stenosis varies greatly in different regions, ages, genders, and races. Aortic stenosis increases the risk of perioperative cardiovascular complications in non cardiac surgery, the risk depends on VHD severity and non cardiac surgery type, the perioperative mortality of untreated severe aortic stenosis patients undergoing non cardiac surgery is high. This review describes the recent progress in the diagnosis, classification, pathological mechanism, treatment and perioperative anesthesia management of aortic stenosis undergoing non-cardiac surgery.
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