在部分腎切除術中服用曼尼托爾後,冠狀動脈:一個病例報告
1Department of Surgery, Gyeongsang National University College of Medicine, Gyeongsang National University Hospital, Jinju, Korea.
Medicine
|August 5, 2025
概括
高剂量的曼尼托尔可以在敏感患者中引发冠状动脉 (CAS),导致心脏事件,如心室动. 这一案例凸显了对高风险个体进行仔细监测和采用替代性保护策略的必要性.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 麻醉学 麻醉学
背景情况:
- 冠状动脉 (CAS) 与自主失衡有关,并可能导致严重的心脏事件,特别是在变异性胸痛患者中.
- 曼尼托尔是一种脏保护剂,可能会激活交感神经系统,在敏感个体中构成CAS的风险.
- 本案例报告涉及机器人辅助手术期间曼尼托尔诱导的CAS的罕见心脏风险.
研究的目的:
- 在机器人辅助手术期间报告一种罕见的曼尼托尔诱导冠状动脉缩 (CAS) 病例.
- 为了强调曼尼托在未被诊断的冠状动脉高反应症患者中的潜在心脏风险.
- 强调个性化的术后管理和心血管监测的重要性.
主要方法:
- 一名66岁的男性接受了机器人辅助的部分切除术.
- 该患者接受了高剂量曼尼托尔输液 (75克),随后出现了心室过早收缩和心室动.
- 进行了跨胸腔心声学,冠状动脉血管学和冠状动脉诱发试验.
主要成果:
- 通过心肺复苏和除恢复了血液循环.
- 冠状动脉扫描显示没有显著的狭窄,但刺激测试证实了显著的CAS和变异性心脏病.
- 患者没有出现神经缺陷而康复,并接受通道阻塞剂治疗.
结论:
- 高剂量的曼尼托尔可以在患有潜在冠状动脉过敏反应的患者中加速危及生命的心脏事件.
- 对高风险患者来说,个性化的术后管理和警的心血管监测至关重要.
- 应考虑使用替代性脏保护策略,以减轻曼尼托尔诱导的CAS的风险.
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