CAJ | 학술논문

目的：探讨颈椎创伤患者手术的麻醉特点及管理。方法对本院2011年10月～2014年10月收治的110例颈椎创伤患者手术的麻醉管理进行总结分析。结果所有患者均安全度过围术期，无死亡病例。60例患者采用手法固定下直视插管，28例患者在可视喉镜辅助下插管，22例患者在清醒下纤维支气管镜引导下气管插管，均插管成功。颈椎创伤患者术中循环稳定性较颈椎病手术患者差，有45例（40.9%）发生低血压，其中有35例（77.8%）使用了麻黄碱。38例（34.5%）发生了心动过缓，其中有33例（86.4%）使用了阿托品。全瘫患者的使用率最高，不全瘫患者使用率高于仅有感觉异常的患者。结论颈椎创伤患者颈部需要有效制动，循环稳定性差。合理管理颈椎创伤患者的气道，维持循环的稳定，积极保护神经功能，可以使患者安全度过围术期。
목적：탐토경추창상환자수술적마취특점급관리。방법대본원2011년10월～2014년10월수치적110례경추창상환자수술적마취관리진행총결분석。결과소유환자균안전도과위술기，무사망병례。60례환자채용수법고정하직시삽관，28례환자재가시후경보조하삽관，22례환자재청성하섬유지기관경인도하기관삽관，균삽관성공。경추창상환자술중순배은정성교경추병수술환자차，유45례（40.9%）발생저혈압，기중유35례（77.8%）사용료마황감。38례（34.5%）발생료심동과완，기중유33례（86.4%）사용료아탁품。전탄환자적사용솔최고，불전탄환자사용솔고우부유감각이상적환자。결론경추창상환자경부수요유효제동，순배은정성차。합리관리경추창상환자적기도，유지순배적은정，적겁보호신경공능，가이사환자안전도과위술기。
Objective To investigate the anesthesia management of patients with cervical spine trauma. Methods In our hospital from 2011 October to 2014 October, 110 cases of cervical trauma patients during the anesthesia management was summarized and analyzed. Results All patients were safe during perioperative period, no death case. 60 cases were treated by manipulation of fixed direct intubation, 28 patients under video laryngoscope assisted intubation, 22 patients in the awake fiberoptic bronchoscopic tracheal intubation was successful. Cervical vertebra trauma patients in patients with cervical spondylosis operation cycle stability is poor, there were 45 cases (40.9%) hypotension occurred, of which 35 cases (77.8%) the use of ephedrine. In 38 cases (34.5%) occurred Beckoning bradycardia, of which 33 cases (86.4%) the use of atropine. Complete paralysis of the highest utilization rate, incomplete paralysis using rate is higher than that of patients with abnormal only feeling. Conclusion Cervical trauma patients with neck need effective braking, the poor cyclic stability. The rational management of cervical trauma patients airway, maintain circulation stability, active protection of nerve function, can make the patient safety through perioperative period.