新生儿脐膨出手术的麻醉管理  

Anesthetic Management in Neonate Omphalocele Operation

作　　者：邱永升[1] 贾英萍[1] 梁郑[1] 李骥[1] 陈忠建[1] 

机构地区：[1]河南省郑州市儿童医院麻醉科,450053

出　　处：《职业与健康》2007年第22期2111-2112,共2页Occupation and Health

摘　　要：目的探讨新生儿脐膨出围手术期的麻醉管理方法。方法32例患儿均采取气管内静吸复合麻醉,诱导用异丙酚,瑞芬太尼,维库溴铵,行气管插管,机械通气,术中异丙酚、瑞芬太尼持续静脉滴注,根据手术情况辅助吸入七氟醚。术后均不拔气管插管,送回SICU,采用呼吸囊或呼吸机辅助呼吸。术后均禁食、胃肠减压5~12 d,完全肠道外营养(TPN)6~10 d。结果2003年以前的8例患儿应用呼吸囊辅助呼吸,3例均因呼吸衰竭而死亡。2003年以后的24例患儿均采用呼吸机辅助呼吸2.5 h^3 d不等。除2例术后放弃治疗外,21例成活,1例因呼吸衰竭死亡。结论先天性脐膨出、虽然是危重的急症,经合适的手术、呼吸机的支持、TPN的治疗,有较高的治愈率。[ Objective] To discuss about the anesthetic management in neonate omphalocele operation. [ Methods]38 omphalocele neonates undertook the operations, in which trachea calm compound anaesthesia was used, induced by propofol , remifcntanil and vecuronium ; trachea intubation and machinery -assisted respiration were conducted ; propofol and remifentanil were continuously transfused into vein; according to the situation, An Fumi was given to the patients for inhalation during the surgery; the patients were send to SICU after the operation with trachea intubation still on, respiratory vesica and respirators were used for auxiliary respiration; post - operation fasting and gastrointestinal decompression were conducted for 5 to 12 days; total parenteral nutrition （ TPN ） was given for 6 to 10 days. [ Results] Among the 8 neonates who were given respiratory vesica for auxiliary respiration before the year of 2003, 3 cases died from respiratory failure; while among the 24 neonates who were given respirator for auxiliary respiration for 2.5h to 3 days after the year of 2003, 21 cases were alive and only one case died from respiratory failure , except for the 2 cases who aban.. doned treatment voluntarily. [ Conclusion] Although congenital omphalocele is a life - threatening acute disease, the cure rate can be improved through appropriate surgery, respirator support and TPN treatment.

关 键 词：脐膨出 机械通气 麻醉 新生儿 

分 类 号：R656[医药卫生—外科学]