Anesthesiology-麻醉学-英文版

章节摘录

版权页：   插图：   1.3.2.5 Kidney With the improvement of medical technology,life expectancy of patients with terminal kidney dis-ease lengthens. These patients are often accompa-nied with other organic or systemic diseases, such ashypertension, arteriosclerosis, anemia, metabolicand endocrine disturbances. However, if combinedwith blood purificatory measures, such as hemodial-ysis, it is no longer a contraindication for electivesurgery. Postoperative renal dysfunction is one of themain causes of perioperative morbidity and mortali-ty. There are many risk factors affecting periopera-rive renal function, including preoperative decreasedrenal function reserve （e. g. the concomitance diabe-tes, hypertension, hypohepatia, etc. ）, surgery-re-lated factors （aortic-clamping surgeries, extracorpo-real circulation, long-term surgeries, massive bloodloss, etc. ） and factors may cause kidney damageduring anesthesia and surgery （e. g. hypotension,hypovolemia and antibiotics, etc. ）. Making certain of preoperative renal functionreserve, proper preoperative preparation and treat-ment, drawing up a plan for risk factors causing re-nal failure are essential for protecting renal functionand improving prognosis. 1.3.2.6 Endocrine system For patients accompanied with different endo-crine system disorders, the focus preoperative prep-aration is different with pathological and physiologi-cal features. For hyperthyroid patients, the keypoint of preoperative preparation is to prevent intra-operative and postoperative thyroid crisis. Anti-thy-roid drugs are usually administrated before surgeryto control the disease, and then use Lugol solution（compound iodine solution） for two weeks, so thatthyroid congestion and swelling can be lightened re-markably. Iodides and propranolol or esmolol can beused compatibly to prepare for the hyperthyroidism.For patients with Cushing's syndrome, it is vital tocorrect the fluid and electrolyte imbalance and theacid-base disturbance before anesthesia, especiallythe potassium supplement, control infection and hy-perglycemia and correct the negative nitrogen bal-ance. For patients with primary aldosteronism, spi-ronolactone or potassium can be applied before oper-ation to correct hypokalemia. For patients withpheochromocytoma, hypertension induced by exces-sive secretion of catecholamine should be controlledto the greatest extent before surgery. We should usea-receptor blockers to dilate blood vessels and applyfluid therapy to expand blood volume simultaneous-ly. For diabetic patients, preoperative fasting bloodglucose should be controlled below 7.7 mmol/L（140 mg/dL） and the maximum should not exceed12.9 mmol/L （198 mg/dL） because hyperglycaemiacan aggravate the cerebral ischemia causing the cere-bral lesion. Patients taking oral hypoglycemic drugspreviously should transfer to subcutaneous insulin orintravenous infusion of insulin before surgery. Forinsulin-dependent diabetic patients, operations cannot be performed unless the acetone bodies are con-trolled negative and the blood glucose is in normalrange, except for emergency surgeries.

书籍目录

Chapter 1 Preanesthetic Evaluation and Preparation 1.1 Introduction 1.2 Preanesthetic Evaluation 1.3 Anesthetic and Surgical Preparation Chapter 2 Regional Block Anesthesia 2.1 Introduction 2.2 Regional Anesthesia and Local Anesthetics 2.3 Peripheral Nerve Block 2.4 Intrathecal Anesthesia Chapter 3 General Anesthesia 3.1 Concept of General Anesthesia 3.2 Related Basic Knowledge 3.3 Management of General Anesthesia 3.4 Complications Chapter 4 Monitoring and Managements during Anesthesia 4.1 Introduction 4.2 Significance and Importance of Monitoring during and after Anesthesia 4. 3 The Basic Standard of Monitoring during Anesthesia 4.4 Contents of Cardiovascular System Monitoring 4. 5 Principles of Circulatory Disturbance Management 4.6 Monitoring Methods and Managements of Respiration during Anesthesia 4.7 Judgments and Managements of Anesthesia Depth 4.8 Commonly Used Monitoring of Body Temperature 4. 9 Monitoring and Managements during Recovery Period after Anesthesia Chapter 5 Fluid Management 5.1 Introduction 5.2 Monitoring of Fluid, Electrolytes and Osmolality 5.3 Principle to Treat Turbulence of Fluid Balance Chapter 6 Shock 6.1 Introduction 6.2 Classification of Shock 6.3 Hypovolemic Shock 6.4 Cardiogenic Shock 6.5 Distributive Shock 6.6 Obstructive Shock Chapter 7 Multiple Organ Dysfunction Syndrome 7.1 Introduction 7.2 Mechanisms of MODS 7.3 Definition of MODS 7.4 Management of MODS Chapter 8 Cardiopulmonary Resuscitation 8.1 The Concept of CPR and CPCR 8.2 Immediate Recognition and Activation of the Emergency Response System 8.3 Basic Life Support 8.4 Advanced Life Support 8.5 Post-resuscitation Treatment （PRT） Chapter 9 Nutritional Aspects 9.1 Introduction 9.2 Nutritional Requirements of Surgical Patients 9.3 Methods of Providing Nutrition Support 9.4 Nutritional Support in Special Situations Chapter 10 Pain Treatment 10.1 Introduction 10. 2 The Concept, Classification and Assessing of Pain 10. 3 The Body Responses of Pain 10.4 The Influence Factors of Pain 10. 5 The Common Methods of Pain Treatment

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《医学教育改革系列教材:Anesthesiology(英文)》由高等教育出版社出版。

作者简介

Anesthesiology（麻醉学），ISBN：9787040343373，作者：田鸣 著

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