破裂脑动脉瘤急性期手术的麻醉管理  

Management of anesthesia for the surgery of ruptured cerebral aneurysms in acute stage

作　　者：杨伶[1] 王中[2] 杨建平[1] 李金泉[2] 周岱[2] 

机构地区：[1]苏州大学附属第一医院麻醉科,215006 [2]苏州大学附属第一医院神经外科,215006

出　　处：《江苏医药》2006年第4期324-325,共2页Jiangsu Medical Journal

摘　　要：目的探讨破裂脑动脉瘤急性期手术过程中的麻醉处理。方法总结225例破裂脑动脉瘤急性期手术中的麻醉要点。采用静脉快速诱导气管内插管全麻、静吸复合维持麻醉、术中保持正常血压,必要时适当降压,夹闭动脉瘤后适当升高血压等方法。结果麻醉诱导及插管阶段未发生脑动脉瘤再破裂。麻醉维持中患者的生命体征基本平稳,225例患者术后3个月时预后良好176例,中残24例,重残15例,死亡10例。结论破裂脑动脉瘤急性期手术诱导麻醉要平稳,术中保持正常血压,必要时适当降压,夹闭动脉瘤后适当升高血压,对提高手术的成功率及预防脑缺血有一定作用。Objective To review the anesthesia management of surgery for patients with ruptured cerebral aneurysms in acute stage. Method Surgeries of 225 cases with ruptured cerebral aneurysms in acute stage were reviewed. Anesthesia was induced with rapid intravenous injection and tracheal intubation, maintained with intravenous-inhalation balanced anesthesia, Controlled hypotension was used necessarily during operation and a suitable high level of blood pressure was kept after clipping. Results No ruptures reoccurred during induction and intubation. The vital signs of all patients were stable during anesthesia. Three months after surgery, 176 patients were with excellent recovery,24 with good recovery , 15 with poor outcome and 10 died. Conclusion Anesthesia with smooth induction, keeping normal blood pressure or using, controlled hypotension when needed during operation, and a suitable hypertension after clipping could prevent the patients from cerebral ischemia and improve the outcomes in the patients with ruptured cerebral aneurysms in acute stage.

关 键 词：动脉瘤 麻醉 

分 类 号：R739.41[医药卫生—肿瘤] R739.410.5[医药卫生—临床医学]