地震伤员的急救与麻醉处理策略
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摘要
目的探讨地震伤员的急救与麻醉处理方法。方法 64例地震伤员经积极的麻醉前准备,合理选择麻醉方法 ,早期有效液体治疗,麻醉期间维持循环、呼吸、肝肾功能,注意生命指标动态变化。结果局部麻醉及静脉麻醉38例,麻醉手术顺利,全部救治成功;26例气管插管全麻伤员有16例清醒拔管安全返回病房,9例保留气管导管送监护室,死亡1例。结论对地震伤员的科学救治、规范施救是减少死亡率和致残率的重要环节;选择恰当的麻醉方法 ,合理的麻醉用药,强有力的呼吸支持,有效的循环功能保护及麻醉恢复期的监管等综合措施是大规模地震伤员救治的根本保证。
Objective To investigate the experience of emergency treatment and anesthesia management of trauma patients in earthquake.Methods Sixty-four cases of trauma patients in earthquake were early treated by effective fluid therapy.Active preparation before anesthesia and reasonable choice of anesthesia were required.We maintained the function of circulation,respiratory,liver and kidney during anesthesia,as well as paid close attention to the dynamic changes of life indicators.Results Thirty-eight cases underwent local anesthesia and intravenous anesthesia were rescued successfully.Tweenty-six cases underwent tracheal intubation anesthesia,in which 16 cases regained consciousness and were sent back to ward with tracheal catheter extubated,9 cases were sent to ICU with tracheal tube maintained and another 1 case died.Conclusion Scientific and standard treatment is important for reducing mortality and disability of trauma patients in earthquake.It is suggested to carry out treatment for trauma patients in massive earthquakes by many comprehensive measures include proper select of anesthesia methods,reasonable use of narcotic drugs,strong respiratory support,effective protection of circulatory function and effective regulation when recovering from anesthesia etc.
Objective To investigate the experience of emergency treatment and anesthesia management of trauma patients in earthquake.Methods Sixty-four cases of trauma patients in earthquake were early treated by effective fluid therapy.Active preparation before anesthesia and reasonable choice of anesthesia were required.We maintained the function of circulation,respiratory,liver and kidney during anesthesia,as well as paid close attention to the dynamic changes of life indicators.Results Thirty-eight cases underwent local anesthesia and intravenous anesthesia were rescued successfully.Tweenty-six cases underwent tracheal intubation anesthesia,in which 16 cases regained consciousness and were sent back to ward with tracheal catheter extubated,9 cases were sent to ICU with tracheal tube maintained and another 1 case died.Conclusion Scientific and standard treatment is important for reducing mortality and disability of trauma patients in earthquake.It is suggested to carry out treatment for trauma patients in massive earthquakes by many comprehensive measures include proper select of anesthesia methods,reasonable use of narcotic drugs,strong respiratory support,effective protection of circulatory function and effective regulation when recovering from anesthesia etc.
引文
[1]王正国.灾害和事故的创伤救治[M].北京:人民卫生出版社,2005:8-12.
[2]李贵森,王莉,何强,等.5.12汶川大地震挤压综合征伤员电解质紊乱特点分析[J].实用医院临床杂志,2010,7(1):45-46.
[3]Gunal AI,Celiker H,Dogukan A,et al.Early ang vigorous fluid resuscita-tion Prevents acute renal failure in the crush victims of catastrophic earth-quakes[J].J Am Soc Nephrol,2004,15(17):1862-1867.
[4]陶军,黄河,方平,等.汶川地震灾区伤员现场救治的麻醉学管理[J].临床麻醉学杂志,2009,25(2):225-227.
[2]李贵森,王莉,何强,等.5.12汶川大地震挤压综合征伤员电解质紊乱特点分析[J].实用医院临床杂志,2010,7(1):45-46.
[3]Gunal AI,Celiker H,Dogukan A,et al.Early ang vigorous fluid resuscita-tion Prevents acute renal failure in the crush victims of catastrophic earth-quakes[J].J Am Soc Nephrol,2004,15(17):1862-1867.
[4]陶军,黄河,方平,等.汶川地震灾区伤员现场救治的麻醉学管理[J].临床麻醉学杂志,2009,25(2):225-227.
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