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产科麻醉相关内分泌急症研究进展
徐冰,程婷婷,黎娜,侯炯*
0
(海军军医大学(第二军医大学)长海医院麻醉学部, 上海 200433
*通信作者)
摘要:
妊娠期母体内分泌系统的生理状态及激素水平发生改变,从而为胎儿的生长发育提供适宜的环境。这些变化对母体的麻醉生理、麻醉药理及麻醉管理方式等均产生重要影响。随着妊娠时间的推移,垂体、甲状腺、胰岛、肾上腺等内分泌器官的变化更加显著,并可能由此引起相应的内分泌急症。产科手术多为急诊手术,任何一种内分泌急症对母体与胎儿来说都可能是致命打击。本文概述了常见的妊娠期内分泌急症及其麻醉处理要点,旨在帮助麻醉医师更好地了解此类问题、掌握相关急症的处理方法与麻醉管理要点。
关键词:  妊娠  内分泌急症  麻醉  甲状腺疾病  葡萄糖代谢障碍
DOI:10.16781/j.0258-879x.2019.01.0074
投稿时间:2018-08-10修订日期:2018-12-14
基金项目:
Obstetric anesthesia-associated endocrine emergencies: an update
XU Bing,CHENG Ting-ting,LI Na,HOU Jiong*
(Department of Anesthesiology, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
During pregnancy, physiological state and hormone level of maternal endocrine system have great changes, providing a suitable environment for fetal growth and development. These physiologic changes have a significant impact on anesthetic physiology, pharmacology and the management techniques. With the progression of pregnancy, the changes of endocrine organs, including pituitary, thyroid, pancreas and adrenal gland are more obvious, and may cause correlated emergencies. Obstetric operations are mostly emergency operations. Any endocrine emergency during pregnancy may be life-threatening for both mothers and fetuses. This review summarizes the common endocrine emergencies during pregnancy and the key steps of diagnosis and treatment, aiming to help anesthesiologists fully understand the changes of maternal physiology, the treatment methods of the emergencies, and the key points of anesthesia management.
Key words:  pregnancy  endocrine emergencies  anesthesia  thyroid diseases  glucose metabolism disorders