国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2014年
9期
821-824
,共4页
雅安芦山地震%汶川地震%麻醉
雅安蘆山地震%汶川地震%痳醉
아안호산지진%문천지진%마취
Ya'an Lushan-earthquake%Wenchuan-earthquake%Anesthesia
目的 比较雅安芦山地震(Ya'an Lushan-earthquake,YLE)与汶川地震(Wenchuan-earthquake,WCE)伤员的麻醉特点,为提高地震救援麻醉水平提供经验. 方法 收集四川大学华西医院麻醉记录完整的YLE和WCE手术伤员相关资料,对比分析手术类型、患者病情、麻醉方法和术中及术后并发症等. 结果 YLE和WCE伤员手术量分别为225例和875例,手术类型以骨折切开复位内固定术为主(YLE 65.3％,WCE 41.7％),且WCE伤员截肢术远高于YLE伤员(11.8％ vs1.8％).YLE伤员美国麻醉医师协会(ASA)分级Ⅰ级所占比例明显低于WCE伤员(4.4％ vs 23.2％),而Ⅳ级伤员所占比例明显高于WCE伤员(8.0％vs 1.4％).地震伤员麻醉以全身麻醉为主(YLE 92.9％,WCE 70.5％),YLE伤员椎管内麻醉所占比例更低(0.8％ vs 13.2％).地震伤员较常见的并发症是低血压(YLE中28例,WCE中73例)、低氧血症(YLE中1例,WCE中42例)和返流误吸(YLE中0例,WCE中13例). 结论 地震伤员手术以骨科手术为主,选择全身麻醉下手术较多,抢救过程中应加强低血压、低氧血症和返流误吸的防治.
目的 比較雅安蘆山地震(Ya'an Lushan-earthquake,YLE)與汶川地震(Wenchuan-earthquake,WCE)傷員的痳醉特點,為提高地震救援痳醉水平提供經驗. 方法 收集四川大學華西醫院痳醉記錄完整的YLE和WCE手術傷員相關資料,對比分析手術類型、患者病情、痳醉方法和術中及術後併髮癥等. 結果 YLE和WCE傷員手術量分彆為225例和875例,手術類型以骨摺切開複位內固定術為主(YLE 65.3％,WCE 41.7％),且WCE傷員截肢術遠高于YLE傷員(11.8％ vs1.8％).YLE傷員美國痳醉醫師協會(ASA)分級Ⅰ級所佔比例明顯低于WCE傷員(4.4％ vs 23.2％),而Ⅳ級傷員所佔比例明顯高于WCE傷員(8.0％vs 1.4％).地震傷員痳醉以全身痳醉為主(YLE 92.9％,WCE 70.5％),YLE傷員椎管內痳醉所佔比例更低(0.8％ vs 13.2％).地震傷員較常見的併髮癥是低血壓(YLE中28例,WCE中73例)、低氧血癥(YLE中1例,WCE中42例)和返流誤吸(YLE中0例,WCE中13例). 結論 地震傷員手術以骨科手術為主,選擇全身痳醉下手術較多,搶救過程中應加彊低血壓、低氧血癥和返流誤吸的防治.
목적 비교아안호산지진(Ya'an Lushan-earthquake,YLE)여문천지진(Wenchuan-earthquake,WCE)상원적마취특점,위제고지진구원마취수평제공경험. 방법 수집사천대학화서의원마취기록완정적YLE화WCE수술상원상관자료,대비분석수술류형、환자병정、마취방법화술중급술후병발증등. 결과 YLE화WCE상원수술량분별위225례화875례,수술류형이골절절개복위내고정술위주(YLE 65.3％,WCE 41.7％),차WCE상원절지술원고우YLE상원(11.8％ vs1.8％).YLE상원미국마취의사협회(ASA)분급Ⅰ급소점비례명현저우WCE상원(4.4％ vs 23.2％),이Ⅳ급상원소점비례명현고우WCE상원(8.0％vs 1.4％).지진상원마취이전신마취위주(YLE 92.9％,WCE 70.5％),YLE상원추관내마취소점비례경저(0.8％ vs 13.2％).지진상원교상견적병발증시저혈압(YLE중28례,WCE중73례)、저양혈증(YLE중1례,WCE중42례)화반류오흡(YLE중0례,WCE중13례). 결론 지진상원수술이골과수술위주,선택전신마취하수술교다,창구과정중응가강저혈압、저양혈증화반류오흡적방치.
Objective To analyze the anesthesia characteristics of Ya'an Lushan-earthquake (YLE) and Wenchuanearthquake (WCE) victims and provide experience for future medical care during disaster rescue.Methods Collecting related anesthesia information from medical records of surgeries performed for the victims during the two earthquake periods in West China Hospital,Sichuan University.The categories of surgery and anesthesia,patients' condition,intraoperative and postoperative complications were compared.Results Two hundred and twenty five surgeries during YLE and 875 surgeries during WCE were performed in West China Hospital.The main category of surgeries was open reduction and internal fixation (YLE 65.3％,WCE 41.7％).More amputations were carried out in WCE(11.8％ vs 1.8％).The victims classified in ASA Ⅰ in YLE were fewer than those in WCE (4.4％ vs 23.2％),while patients with the ASA Ⅳ were more in YLE (8.0％ vs 1.4％).The main anesthesia method was general anesthesia during both earthquakes (YLE 92.9％,WCE 70.5％).Epidural anesthesia was performed less in YLE (0.8％ vs 13.2％).The most common intraoperative complications were hypotension(YLE n=28,WCE n=73),hypoxemia (YLE n=1,WCE n=42) and aspiration (YLE n=0,WCE n=13).Conclusions The main category of surgeries for earthquake victims was orthopedics.Most surgeries were performed under general anesthesia.The earthquake victims were commonly followed by a variety of serious complications.Hypotension,hypoxemia and aspiration should be avoided during the rescue.
