老年全麻318例临床分析  

Clinical Analysis of General Anaesthesia-characteristics of318 old Patients

作　　者：刘可军[1] 王尔民[1] 刘小霞[1] 

机构地区：[1]德州市人民医院,山东德州253014

出　　处：《实用医技杂志》2004年第10A期1996-1997,共2页Journal of Practical Medical Techniques

摘　　要：目的 :分析和总结老年患者手术麻醉的临床特点。方法 :318例 ASA 级～ 级、择期全麻手术的老年患者 ,其中 2 38例合并明显高血压、心脏病、糖尿病等。麻醉诱导采用异丙酚、芬太尼、琥珀胆碱静脉推注 ,以维库溴铵维持肌松、吸入异氟醚及间断静注芬太尼维持麻醉 ,术中严密观察患者的血压、心率、心电图、血氧饱和度等变化 ,记录术毕延迟苏醒的例数。结果 :术中有 12 2例发生血压、心率明显改变 ,术毕延迟苏醒 71例 ,有明显合并症者延迟苏醒的发生率为 2 5 .6 3% ,而无明显合并症者发生率仅为 12 .5 0 % ,两者具差异有非常显著性 (P<0 .0 1) ;结论 :老年全麻手术病人常合并有多种疾病 ,加强围麻醉期的管理及有效处理 ,可明显提高麻醉安全性 ,减少术中术后并发症的发生。Objective To analyze and summarize the general anaesthesia-characteristics of old patients.Methods 318 old patients,ASA grade Ⅰ~Ⅲ,scheduled for elective generalanaesthesia-surgery,were selected in the study,including 238 ones who suffered from hypertension,heart disease,diabetes et al.Anaesthesia was induced by intermittent injection of propofol,fentanyl and succinylcholine,maintained by vecuronium,fentanyl iv and isoflurane inhalation.Blood pressure,heart rate,ECG,SpO 2 Were observed carefully,and delayed revivals wererecorded,Results Great Changes of blood pressure andheart rate were found in 122 old patients,in which there were 71 delayed revivals contemporaly. The rate of delayedrevivals(25.63 %) of those who suffered from complications washigher than that(12.50 %) of noncomplications,diffence between themwas signiflcant(P<0.01).Conclusion old patients undergeneral anaesthesia-surgery numerously suffered frommulti-complications,Enhancing the management of peri-anaesthesia can increase anaesthesia-safety obviously,reduce the occurrence of the in-or-postoperative complications.

关 键 词：苏醒 术中 老年患者 全麻手术 心电图 芬太尼 血压 结论 合并 心率 

分 类 号：R614.2[医药卫生—麻醉学]