潍坊医学院学报
濰坊醫學院學報
유방의학원학보
JOURNAL OF WEIFANG MEDICAL COLLEGE
2015年
3期
203-205
,共3页
宋兆卿%王静%马宇%吉栋
宋兆卿%王靜%馬宇%吉棟
송조경%왕정%마우%길동
颅内动脉瘤%全身麻醉%介入微创治疗%辐射
顱內動脈瘤%全身痳醉%介入微創治療%輻射
로내동맥류%전신마취%개입미창치료%복사
Intracranial aneurysm%General anesthesia%Interventional treatment%Radiation
目的:总结微创介入治疗颅内动脉瘤手术的麻醉特点。方法回顾总结323例颅内动脉瘤介入治疗的麻醉管理经验。所有患者均采用吸入七氟烷为主并辅助右旋美托咪啶持续输注的全身麻醉方法完成。术中麻醉医师采用综合方法做好自身防护。结果大部分患者手术过程顺利,手术结束后患者可以迅速平静苏醒,并配合专科医师进行神经功能评估。4例患者(其中男3例,女1例)术中突然出现血压升高,心率加快(超过基础值的30%),确诊为动脉瘤破裂出血,立即控制血压配合外科操作控制出血。1例女性患者填塞不满意,迅速转运手术室开颅手术治疗,恢复良好。结论麻醉医师应熟悉手术的操作步骤和可能面临的意外情况,在避免辐射远离患者情况下保障麻醉安全,手术结束后应该使患者迅速平静苏醒。在保障患者安全前提下,做好自我防护。
目的:總結微創介入治療顱內動脈瘤手術的痳醉特點。方法迴顧總結323例顱內動脈瘤介入治療的痳醉管理經驗。所有患者均採用吸入七氟烷為主併輔助右鏇美託咪啶持續輸註的全身痳醉方法完成。術中痳醉醫師採用綜閤方法做好自身防護。結果大部分患者手術過程順利,手術結束後患者可以迅速平靜囌醒,併配閤專科醫師進行神經功能評估。4例患者(其中男3例,女1例)術中突然齣現血壓升高,心率加快(超過基礎值的30%),確診為動脈瘤破裂齣血,立即控製血壓配閤外科操作控製齣血。1例女性患者填塞不滿意,迅速轉運手術室開顱手術治療,恢複良好。結論痳醉醫師應熟悉手術的操作步驟和可能麵臨的意外情況,在避免輻射遠離患者情況下保障痳醉安全,手術結束後應該使患者迅速平靜囌醒。在保障患者安全前提下,做好自我防護。
목적:총결미창개입치료로내동맥류수술적마취특점。방법회고총결323례로내동맥류개입치료적마취관리경험。소유환자균채용흡입칠불완위주병보조우선미탁미정지속수주적전신마취방법완성。술중마취의사채용종합방법주호자신방호。결과대부분환자수술과정순리,수술결속후환자가이신속평정소성,병배합전과의사진행신경공능평고。4례환자(기중남3례,녀1례)술중돌연출현혈압승고,심솔가쾌(초과기출치적30%),학진위동맥류파렬출혈,립즉공제혈압배합외과조작공제출혈。1례녀성환자전새불만의,신속전운수술실개로수술치료,회복량호。결론마취의사응숙실수술적조작보취화가능면림적의외정황,재피면복사원리환자정황하보장마취안전,수술결속후응해사환자신속평정소성。재보장환자안전전제하,주호자아방호。
Objective Summarize anesthesia management characteristics for interventional treatment of intracranial aneurysm ca-ses.Methods Three huandred and twenty-three anesthesia management of interventional treatment of intracranial aneurysm cases were re-viewed.All cases were completed by inhaling sevoflurane and infusion of dexmedetomidine as anesthetic adjunct during anesthesia.Anesthe-tists protected themselves from radiation during operation by integrated approach.Results Most of the patients accepted surgeries successful-ly.Anesthesia recovery period were short and calm.Patients could cooperate with surgeons for neural function evaluation calmly.Blood pres-sure and heart rate increasing sharply happened in 4 cases(3 male patients and 1female patient) and ruptured cerebral aneurysm were diag-nosed.Anesthetists quickly controlled circulation to cooperate with surgical coiling hemostasis.The hemostasis for female patient was not suc-cessfully.The patient was transfered to operation room quickly and accepted emergence craniotomy for clipping of the aneurysm successfully. Conclusion During interventional treatment of intracranial aneurysm,anesthetists were away from patients.Anesthetists should familiar with surgical procedures and complications during operation.Make patients awake from anesthesia quickly and calmly.On the premise of patients safe,anesthetists should be familiar with protecting themselves in radiation environment.