CAJ | 학술논문

目的：探索颅内动脉瘤夹闭术的麻醉处理方法。方法：采用静脉快速诱导气管插管、静吸复合维持麻醉,维持适当的颅内动脉跨壁压预防瘤体破裂,围术期采用钙通道阻滞剂预防脑血管痉挛,采取脑保护措施预防神经系统并发症,对65例颅内动脉瘤患者进行麻醉处理。结果：全部患者麻醉均成功,无手术死亡病例。术中动脉瘤破裂2例,通过外科医师放置临时动脉夹或者短时压迫同侧颈动脉来控制出血；同时胶体扩容,采用自体血回输机回输自体血；血管活性药物泵注,保持尿量>1~2 ml/kg/h,最终顺利完成手术。结论：麻醉诱导平稳,谨慎地控制血管的跨壁压,术前及术中预防脑血管痉挛并脑并发症是麻醉成功的关键。
목적：탐색로내동맥류협폐술적마취처리방법。방법：채용정맥쾌속유도기관삽관、정흡복합유지마취,유지괄당적로내동맥과벽압예방류체파렬,위술기채용개통도조체제예방뇌혈관경련,채취뇌보호조시예방신경계통병발증,대65례로내동맥류환자진행마취처리。결과：전부환자마취균성공,무수술사망병례。술중동맥류파렬2례,통과외과의사방치림시동맥협혹자단시압박동측경동맥래공제출혈；동시효체확용,채용자체혈회수궤회수자체혈；혈관활성약물빙주,보지뇨량>1~2 ml/kg/h,최종순리완성수술。결론：마취유도평은,근신지공제혈관적과벽압,술전급술중예방뇌혈관경련병뇌병발증시마취성공적관건。
[ Abstract] Objective: To investigate the perioperative anesthesia management of the surgery for intracranial aneu-rysm. Methods:Inhalation-intravenous anesthesia was applied after intravenous rapid induction of endotracheal intubation. Proper intracranial arterial pressure was maintained to prevent the rupture of aneurysms. Calcium channel blockers were a-dopted to prevent the cerebrovascular spasm and brain protection measures were used to prevent neurosystem complications. Totally 65 cases of intracranial aneurysm were involved in this study. Results:All patients successfully underwent the an-esthesia without operation related death. Intraoperative aneurysm rupture occurred in 2 cases. Bleeding was controlled by placing temporary artery clamp or ipsilateral carotid artery oppression. At the same time, colloid was added to expand plas-ma volume . Autologous blood was transfused with cell saver. Vascular active drugs were injected with pump to maintain the urine output>1~2 ml/kg/h. Conciusion:The keys of perioperative anesthesia management of intracranial aneurysm are ideal control of arterial pressure, prevention of cerebrovascular spasm and neurological complications pre-and intra-oper-atively.