Page 36 - CASA Bulletin 2019 Vol6 No2

CASA Bulletin of Anesthesiology
就要考虑到术中处理为术后重症监护创造较好的恢复条件，具体体现在合理的麻醉方法
选择、适度的容量补充、适当利尿、合理血管活性药物和正性肌力药的使用以及完善的
术后镇痛方案。这也是保证重症心脏病孕产妇围术期处理连续性的重要措施。各专科人
员在心脏病孕产妇围术期管理过程中，均需要考虑的一个关键问题，那就是各个处理环
节均应以利于患者顺利度过围术期、改善最终结局(康复出院)为目标。
小结
重症肺高压孕产妇围生期极易出现肺动脉高压危象，死亡率高，临床医师要引起足够
的重视。高质量的多学科团队协作，对改善母婴结局极为重要。临床处理上要以更加合
理的、连续的个体化的治疗方案。一经确诊，原则上尽早终止妊娠。麻醉方式推荐硬膜
外阻滞麻醉，避免“危重患者就要一概应用全身麻醉”的临床惯性思维，术中设法避免
血流动力学波动，积极预防肺动脉高压危象等严重不良心脏事件发生。
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