现代诊断与治疗
現代診斷與治療
현대진단여치료
MODERN DIAGNOSIS AND TREATMENT
2014年
3期
481-483
,共3页
重型颅脑损伤%急诊手术%麻醉
重型顱腦損傷%急診手術%痳醉
중형로뇌손상%급진수술%마취
Severe brain injury%Emergency surgery%Anesthesia
目的：研究分析重型颅脑损伤患者急诊手术中的麻醉方法。方法选取我院急诊手术治疗的重型颅脑损伤患者共40例，回顾性分析急诊手术中的麻醉方法和麻醉效果。结果患者HR、SBP、DBP术后水平分别为104.25±6.49次/min、13.08±3.94KP、6.52±0.84KP，均较术前得到改善（P＜0.01）；25例术中异氟烷维持麻醉患者，未见死亡，术中至苏醒过程未见明显血压波动，并发症1例；15例术中丙泊酚维持麻醉的患者，1例死亡（因脑部并发症死亡），4例术中至苏醒血压等明显波动。异氟烷术中维持麻醉效果优于丙泊酚术中维持麻醉，差异显著（P＜0.05）。40例患者住院时间为20.4±2.7d，术后切口疼痛时间为2.2±0.4d；术中死亡率为2.5%，术中并发症发生率为2.5%。结论重型颅脑损伤患者急诊手术在维持呼吸通畅、供氧、抗休克、扩容同时，灵活结合病情选择麻醉方式与麻醉用药，可有效降低病死率、缩短住院时间和术后切口疼痛时间。
目的：研究分析重型顱腦損傷患者急診手術中的痳醉方法。方法選取我院急診手術治療的重型顱腦損傷患者共40例，迴顧性分析急診手術中的痳醉方法和痳醉效果。結果患者HR、SBP、DBP術後水平分彆為104.25±6.49次/min、13.08±3.94KP、6.52±0.84KP，均較術前得到改善（P＜0.01）；25例術中異氟烷維持痳醉患者，未見死亡，術中至囌醒過程未見明顯血壓波動，併髮癥1例；15例術中丙泊酚維持痳醉的患者，1例死亡（因腦部併髮癥死亡），4例術中至囌醒血壓等明顯波動。異氟烷術中維持痳醉效果優于丙泊酚術中維持痳醉，差異顯著（P＜0.05）。40例患者住院時間為20.4±2.7d，術後切口疼痛時間為2.2±0.4d；術中死亡率為2.5%，術中併髮癥髮生率為2.5%。結論重型顱腦損傷患者急診手術在維持呼吸通暢、供氧、抗休剋、擴容同時，靈活結閤病情選擇痳醉方式與痳醉用藥，可有效降低病死率、縮短住院時間和術後切口疼痛時間。
목적：연구분석중형로뇌손상환자급진수술중적마취방법。방법선취아원급진수술치료적중형로뇌손상환자공40례，회고성분석급진수술중적마취방법화마취효과。결과환자HR、SBP、DBP술후수평분별위104.25±6.49차/min、13.08±3.94KP、6.52±0.84KP，균교술전득도개선（P＜0.01）；25례술중이불완유지마취환자，미견사망，술중지소성과정미견명현혈압파동，병발증1례；15례술중병박분유지마취적환자，1례사망（인뇌부병발증사망），4례술중지소성혈압등명현파동。이불완술중유지마취효과우우병박분술중유지마취，차이현저（P＜0.05）。40례환자주원시간위20.4±2.7d，술후절구동통시간위2.2±0.4d；술중사망솔위2.5%，술중병발증발생솔위2.5%。결론중형로뇌손상환자급진수술재유지호흡통창、공양、항휴극、확용동시，령활결합병정선택마취방식여마취용약，가유효강저병사솔、축단주원시간화술후절구동통시간。
Objective To study the anesthesia methods in severe head injury of emergency opera-tion. Methods Methods and effects of anesthesia in 40 patients with severe brain injury treated by emergency surgery were retrospectively analyzed. Results The level of HR、SBP、DBP after operation were 104.25±6.49 times/min,13.08±3.94KP,6.52±0.84KP,improved than before the surgery (P<0.01). No death but one complication was in 25 patients with isoflurane anesthesia, with no significant fluctuations in blood pressure.One died in 15 patients with propofol anesthesia, with significant fluctuations in blood pressure in 4 cases in intraoperative to wake up.The effect of isoflurane in intraoperative maintenance of anesthesia was better than propofol, the difference was significant. The hospitalization was 20.4 ±2.7d,postoperative wound pain time was 2.2 ±0.4d;death rate during operation was 2.5%,complication rate during operation was 2.5%. Conclusions In the basis of maintaining unobstructed breathing, oxygen, anti-shock, expansion, flexible choicing of anesthesia with the disease and anesthesia medication, in emergency surgery in patients with se-vere traumatic brain injury, can effectively reduce mortality, shorter hospital stay and postoperative incisional pain time.
