2024 年第 6 期 第 19 卷

颈动脉夹层血管内支架植入术中心脏停搏1例麻醉管理

Anesthesia management of one case of cardiac arrest during carotid artery dissection endovascular stenting

作者：苏燕朱蓓蓓

英文作者：Su Yan Zhu Beibei

单位：  南京大学医学院附属鼓楼医院南京鼓楼医院麻醉科，南京210008

英文单位：Department of Anesthesiology Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School Nanjing 210008 China

关键词：麻醉管理；恶性心律失常；心脏停搏；急性循环衰竭；颈动脉支架植入术

英文关键词：Anestheticmanagement;Malignantarrhythmia;Cardiacarrest;Acutecirculatorycollapse; Carotidarterystenting

• 摘要：

• 颈动脉夹层在临床上是一种相对少见的疾病，而在此手术过程中发生严重心血管不良事件的报道更为罕见。颈动脉支架植入术（CAS）因其创伤小、并发症少而广泛应用于颈动脉夹层的治疗，一旦发生急性循环衰竭，实施有效的麻醉管理对于挽救患者生命尤为关键。本文报道1例合并复杂基础疾病的颈动脉夹层患者，在CAS术中突发恶性心律失常、心脏停搏、急性循环衰竭的麻醉管理方案，通过实施目标导向的个体化麻醉管理程序最终成功抢救，患者好转出院。

• Carotid artery dissection is a relatively rare disease in clinical practice, and reports of serious adverse cardiovascular events during this procedure are even rarer. Carotid artery stenting (CAS) is widely used in the treatment of carotid artery dissection because of its small trauma and few complications. Once acute circulatory failure occurs, the implementation of effective anesthesia management is particularly key to save the patient′s life. This article reports a case of carotid artery dissection patient with complex underlying diseases. Anesthesia management plan for sudden malignant arrhythmia, cardiac arrest, and acute circulatory failure during CAS was implemented. Through the implementation of goal-directed individualized anesthesia management program, the patient was finally rescued and discharged.