12例麻醉相关心跳骤停原因分析  

Causes analysis of 12 cases of anesthesia-related cardiac arrest

作　　者：江辉[1] 巴德玛[1] 刘凌云[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉学教研室,武汉430030

出　　处：《临床内科杂志》2013年第9期618-620,共3页Journal of Clinical Internal Medicine

摘　　要：目的 分析非心脏手术患者麻醉相关心搏骤停（ACA）的原因.方法 收集1992年1月～2011年12月我院住院手术患者434 573例（其中急诊患者87 829例）病历资料,选择非心脏手术ACA患者,分析患者心搏骤停的原因、患者特征、复苏成功率或死亡率,并对结果进行统计分析.结果 筛选出12例麻醉相关心搏骤停患者,呼吸心跳骤停原因包括气管导管置入失败、术中低供氧、术中突发肺栓塞（尸检报告结果）、全脊髓麻醉急性溶血反应等;急诊手术和非标准工作时间手术ACA发生率显著增高,心跳停止5分钟之内复跳的患者抢救成功率显著增高.结论 充分术前准备、正确的麻醉选择、完善的术中监护和及时抢救措施是防止围术期心搏骤停和提高救治水平的重要环节.Objective To analyze the reasons of anesthesia-related cardiac arrest（ACA） in noncardiac surgery in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology for the last 20 years.Methods The clinical data of 434573 inpatient surgery patients （including 87 829 emergency patients）from January 1992 to December 2011 in Tongji Hospital were collected,noncardiac surgery ACA （after anesthesia or cardiac arrest required cardiopulmonary resuscitation duo to anesthesia after the start of surgery） patients were selected to analyzed the reasons for ACA,the patient＇ s characteristics,the success ratio of resuscitation or mortality.SPSS 10.0 was used for statistical analysis.Occurrence of the event ratio were analyzed using the chi-square test.Results 12 cases of ACA patients were screened.We found that reasons for respiratory and cardiac arrest including intubation failure,hypoxia in surgery,sudden pulmonary embolism （autopsy results）,total spinal anesthesia and acute hemolytic reaction.ACA incidence is higher in the emergency surgery and non-standard working hours surgery.The success ratio of ACA patients within five minutes of resuscitation is significantly higher.Conclusion Full preoperative preparation,reasonable anesthesia options,complete intraoperative monitoring and timely rescue measures is an important part in preventing perioperative ACA and improving the therapeutic level.

关 键 词：麻醉 心搏骤停 复苏 

分 类 号：R614.42[医药卫生—麻醉学]