新生儿先天性腹壁缺损的麻醉管理  

Anesthetic management in neonates with congenital abdominal wall defects

作　　者：莫丽平[1] 冯继峰[1] 苏乃伟[2] 

机构地区：[1]广西壮族自治区妇幼保健院麻醉科,南宁530003 [2]广西壮族自治区妇幼保健院外科,南宁530003

出　　处：《西南国防医药》2013年第5期496-498,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨新生儿先天性腹壁缺损手术的麻醉管理措施。方法对32例新生儿先天性腹壁缺损的麻醉资料进行回顾性分析,所有患儿均采用气管内插管静吸复合全身麻醉,术中记录体温(T)、出血量、尿量及输入液体总量,记录并比较麻醉前后、还纳腹腔脏器及术毕时段心率(HR)、平均动脉血压(MBP)、血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)的差异。结果麻醉过程平稳,还纳腹腔脏器后出现短暂SpO2及MBP降低(P<0.05),HR及PETCO2升高(P<0.05),但术毕恢复至术前(P>0.05)。术中低体温4例,经处理后恢复正常,无麻醉死亡病例。术后治愈出院31例,死亡1例。结论新生儿先天性腹壁缺损手术麻醉成功的关键是术前积极准备、正确的麻醉方法、术中及围手术期减轻腹压对呼吸与循环的影响。Objective To discuss the anesthetic management measures in neonates receiving the operation on congenital abdominal wall defects （AWD）. Methods Retrospective analysis was made in the anesthetic data of 32 neonates with AWD. All infants received endotracheal intubation general anesthesia. During the operation, their temperature, blood loss, urine volume, and the input volume were recorded. Their heart rate （HR）, mean arterial blood pressure （MBP）, blood oxygen saturation （SpO2 ）, and partial pressure of carbon dioxide in endexpiratory gas （ PET CO2 ） were recorded and compared before and after the anesthesia, at the time of abdominal organ recovery, and at the end of the operation. Results The anesthetic process was stable. After the recovery of abdominal organs,SpO2 and MBP decreased for a short time （P 〈 0.05）. The HR and PET CO2 increased （P 〈 0. 05） but returned to the preoperative level at the end of the operation （P 〉 0.05 ）. During the operation, low temperature occurred in 4 patients who recovered to the normal level after the treatment. There was no anesthetic death. Thirty one cases were healed and discharged, and one case wasdied. Conclusion The keys to the success of anesthesia for AWD are preoperative active preparation, correct anesthetic method, and decrease the effects of abdominal pressure on breathing and circulation during the operation and in the perioperative period.

关 键 词：麻醉 新生儿 腹壁缺损 

分 类 号：R614.2[医药卫生—麻醉学]