颅内动脉瘤介入微创治疗麻醉经验分析  

The Experience of Anesthesia for Interventional Treatment of Intracranial Aneurysm

作　　者：宋兆卿 王静[1] 马宇[2] 吉栋[2] 

机构地区：[1]潍坊市中医院麻醉科,山东潍坊261041 [2]上海市长海医院麻醉科

出　　处：《潍坊医学院学报》2015年第3期203-205,共3页Acta Academiae Medicinae Weifang

摘　　要：目的总结微创介入治疗颅内动脉瘤手术的麻醉特点。方法回顾总结323例颅内动脉瘤介入治疗的麻醉管理经验。所有患者均采用吸入七氟烷为主并辅助右旋美托咪啶持续输注的全身麻醉方法完成。术中麻醉医师采用综合方法做好自身防护。结果大部分患者手术过程顺利,手术结束后患者可以迅速平静苏醒,并配合专科医师进行神经功能评估。4例患者(其中男3例,女1例)术中突然出现血压升高,心率加快(超过基础值的30%),确诊为动脉瘤破裂出血,立即控制血压配合外科操作控制出血。1例女性患者填塞不满意,迅速转运手术室开颅手术治疗,恢复良好。结论麻醉医师应熟悉手术的操作步骤和可能面临的意外情况,在避免辐射远离患者情况下保障麻醉安全,手术结束后应该使患者迅速平静苏醒。在保障患者安全前提下,做好自我防护。Objective Summarize anesthesia management characteristics for interventional treatment of intracranial aneurysm ca-ses.Methods Three huandred and twenty-three anesthesia management of interventional treatment of intracranial aneurysm cases were re-viewed.All cases were completed by inhaling sevoflurane and infusion of dexmedetomidine as anesthetic adjunct during anesthesia.Anesthe-tists protected themselves from radiation during operation by integrated approach.Results Most of the patients accepted surgeries successful-ly.Anesthesia recovery period were short and calm.Patients could cooperate with surgeons for neural function evaluation calmly.Blood pres-sure and heart rate increasing sharply happened in 4 cases（3 male patients and 1female patient） and ruptured cerebral aneurysm were diag-nosed.Anesthetists quickly controlled circulation to cooperate with surgical coiling hemostasis.The hemostasis for female patient was not suc-cessfully.The patient was transfered to operation room quickly and accepted emergence craniotomy for clipping of the aneurysm successfully. Conclusion During interventional treatment of intracranial aneurysm,anesthetists were away from patients.Anesthetists should familiar with surgical procedures and complications during operation.Make patients awake from anesthesia quickly and calmly.On the premise of patients safe,anesthetists should be familiar with protecting themselves in radiation environment.

关 键 词：颅内动脉瘤 全身麻醉 介入微创治疗 辐射 

分 类 号：R614.2[医药卫生—麻醉学]