严重口腔颌面部创伤的急救与麻醉处理  

Emergency Treatment and Anesthesia for Serious oral and Maxillofacial Trauma

作　　者：王瑛[1] 王蕾[1] 

机构地区：[1]内蒙古医学院附属医院麻醉科,内蒙古呼和浩特010050

出　　处：《内蒙古医学杂志》2009年第9期1070-1072,共3页Inner Mongolia Medical Journal

摘　　要：目的:分析和总结口腔颌面部创伤的急救和麻醉处理。方法:回顾近5年我院70例口腔、颌面部严重创伤及手术的急救与麻醉。结果:术前1例病人气管切开,术毕拔管后3例病人发生口腔颌面部出血,出现呼吸困难,2例病人术后气管切开。结论:此类病人急救的关键在于通过气管插管迅速准确的建立通畅的呼吸道;迅速吸净创面、口腔、呼吸道的血液、分泌物、异物;因麻醉机和麻醉医生远离病人的头部,术中时刻警惕气管导管的位置,有无脱落、梗阻;同时注意血容量,积极扩容抗休克治疗;麻醉苏醒期严格掌握拔管指征,注意手术部位有无出血、渗血,拔管后有无气道梗阻及呼吸困难。Objective： To analize and summarize the experience about the emergency and anesthesia treatment of serious oral and maxillofacial trauma . Methods： Analyse the anesthesia and emergency methods for 70 serious oral and maxillofacial trauma surgeries in the 5 years. Results： One patient had been tracheostomized before operation. Three patients had dyspnea soon after extubation because of bleeding and two patients had been tracheostomized after operation. Conclusion： It can be concluded that in serious oral maxillofacial trauma , the key points in the emergency treatment are ： establishment of free airway immediately by early intubation. Clean up the blood , secretion or foreign bodies in the wound . Because of the anesthetic machine and anesthetist are relatively far from the patient＇s head , attentions should be paid to position of the trachealtube, whether it is dislocated, or blocked, blood volume, active anti - shock treatment; indication of the extubation should be strictly mastered. Attentions should also be paid to whether there are bleeding in the surgical field, and whether there is respiratory passage block and difficulty of respiration after extubation.

关 键 词：口腔 颌面部 创伤 急救 麻醉 

分 类 号：R782.05[医药卫生—口腔医学]