“5.12”地震后伤员紧急救治的麻醉管理探讨
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摘要
目的通过"5.12"地震后伤员的紧急救治,探讨对成批伤员的麻醉管理。方法全身麻醉、椎管内麻醉、神经阻滞。结果全组142例患者,4例带气管导管回ICU,其余全部返回临时病房,无1例麻醉死亡,无麻醉并发症、呕吐、误吸、肌松药残留、苏醒延迟等发生,无麻醉差错发生。结论应急状况下大批伤员紧急救治的麻醉应加强科室团队合作,严格的麻醉流程管理,恰当的麻醉方法选择、输血、输液、麻醉药物拮抗、体温保护、感染控制等多个环节控制,以保障麻醉安全,并使更多伤员获得第一时间的手术时机。
Objective To discuss anesthetic administration of massive injured patients through emergent rescue after earthquake on May,12.Methods General anesthesia,intraspinal anesthesia and nerve block.Results Among all 142 cases,4 cases went to ICU with treacheal intubation,others went to temporary wards.None died of anesthetic cause.No anesthetic complications happened such as vomiting,aspiration,residue of muscle relaxant or analepsia delay.Conclusion Intradepartment cooperation and multi-element control including strict anesthetic flow process administration,choosing of proper anesthetic methods,liquid and blood transfusion,temperature preservation and infection prevention should be emphasized to secure patients first-time operation opportunity and anesthetic safety under emergent massive patients rescue.
Objective To discuss anesthetic administration of massive injured patients through emergent rescue after earthquake on May,12.Methods General anesthesia,intraspinal anesthesia and nerve block.Results Among all 142 cases,4 cases went to ICU with treacheal intubation,others went to temporary wards.None died of anesthetic cause.No anesthetic complications happened such as vomiting,aspiration,residue of muscle relaxant or analepsia delay.Conclusion Intradepartment cooperation and multi-element control including strict anesthetic flow process administration,choosing of proper anesthetic methods,liquid and blood transfusion,temperature preservation and infection prevention should be emphasized to secure patients first-time operation opportunity and anesthetic safety under emergent massive patients rescue.
引文
[1]高劲谋.多发伤和创伤评分[J].中华创伤杂志,2007,3:161~163
[2]高劲谋,曾因明,陈伯銮主编.现代麻醉学[M].北京:人民卫生出版社,2004,1328~1329
[3]Wetzel RC,Multiple,trrauma in children:critical care overview[J].CritCare Med,2002,30:468~477
[4]沈其猷,李培,刘彪,等.创伤后MODS危险因素分析[J].中华创伤杂志,2007,7:513~534
[2]高劲谋,曾因明,陈伯銮主编.现代麻醉学[M].北京:人民卫生出版社,2004,1328~1329
[3]Wetzel RC,Multiple,trrauma in children:critical care overview[J].CritCare Med,2002,30:468~477
[4]沈其猷,李培,刘彪,等.创伤后MODS危险因素分析[J].中华创伤杂志,2007,7:513~534
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