复合伤失血性休克患者围术期的麻醉处理  

Intra-operative anesthetic management in complicated trauma patients with hemorrhagic shock

作　　者：王展麟[1] 冯肇洪[1] 张坤全[1] 闫俊香[1] 

机构地区：[1]广东省肇庆市第一人民医院,广东肇庆526021

出　　处：《中国当代医药》2010年第20期75-76,共2页China Modern Medicine

摘　　要：目的:总结复合伤失血性休克患者围术期麻醉处理和成功救治过程。方法:对76例复合伤失血性休克患者的救治及麻醉处理进行回顾,总结分析其麻醉方法和救治措施,包括:①建立有效的静脉通道快速扩容,维持最低有效灌注压,缩短休克时间;②麻醉选择要求占时短,循环干扰小,又保证氧供和提高有效动脉血氧,同时能抑制有害应激反应和消除患者紧张不安的情绪,避免或慎用对循环有抑制作用的麻醉药和扩血管药。结果:除1例肝肾破裂失血过多死于术中外,3例术后1～3d死于多脏器衰竭,其余72例抢救成功,抢救成功率为94.74%。结论:复合伤失血性休克患者采用快速有效的液体复苏,及时处理并发症,选择气管插管全麻是抢救成功的关键。Objective： To sum up the anesthetic management and therapy for the hemorrhagic shock patients intraoperative period. Methods： Reviewed the anesthesia and therapy of the 76 hemorrhagic shock patients,include ①creating effective intravenous rapid expansion to keep the least effective perfusion pressure and shorten the time of shock; ②choosing the anesthesia that take the less time,have less interfere with circulation, provide oxygen enough and improve arterial partial pressure of oxygen,can restrain harmful stress reaction and remove patients′ nervous and the same time.Avoid or using carefully drugs can restrain circulation and causing dilation of blood vessels. Results： 72 patients were rescued successfully,one patient died of liver kidney rupture and 3 patients died of multiple system organ failure.The rehabilitation rate was 94.74%. Conclusion： The key of rescue the patients have hemorrhagic shock cause by complicated trauma are creating effective liquid resuscitation,treat the complications in time,use endotracheal intubations to general anesthetic.

关 键 词：复合创伤 休克 围术期 麻醉处理 

分 类 号：R605.971[医药卫生—急诊医学]