地震掩埋伤员的麻醉处理
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摘要
目的总结地震掩埋伤患者的麻醉处理及注意事项。方法回顾性分析了16例掩埋伤患者的19例次麻醉情况、特殊患者的处理以及术中监测和麻醉管理要点。结果除个别危重患者(长时间掩埋)术中出现与容量和麻醉深度无关的血压、心率波动外,麻醉效果满意,所有全身麻醉患者术后顺利拔管,无麻醉相关并发症发生。结论地震掩埋伤患者、尤其是长时间掩埋伤员适当的术前准备和麻醉选择非常重要,麻醉中加强心肺等重要脏器功能监测和维护是麻醉成功的重要环节,危重患者血流动力学不稳定可能与强烈应激后植物神经功能紊乱有关。
Objective To summarize the anesthetic management and announcement of wounded patients buried in earthquake.Methods The anesthesia informations of 19 times,the management of specific case,and the monitoring and main points of anesthesia were analyzed respectively.Results All anesthetic managements were successful,the patients with general anesthesia were extubated smoothly and no complication associated anesthesia happened except a few patients(buried for long time) with the undulation of blood pressure and heart rate independent to blood volume and depth of anesthesia.Conclusion The adequate preoperative preparation and the choice of anesthesia for the wounded patient buried in earthquake(especially buried for long time) may be very important,the significant component of anesthesia should strengthen the monitoring and maintenance of vital organs such as heart and lung,the instability of haemodynamics in the critical patients would be contributed to the functional disorder of autonomic nerve after intensity stress.
Objective To summarize the anesthetic management and announcement of wounded patients buried in earthquake.Methods The anesthesia informations of 19 times,the management of specific case,and the monitoring and main points of anesthesia were analyzed respectively.Results All anesthetic managements were successful,the patients with general anesthesia were extubated smoothly and no complication associated anesthesia happened except a few patients(buried for long time) with the undulation of blood pressure and heart rate independent to blood volume and depth of anesthesia.Conclusion The adequate preoperative preparation and the choice of anesthesia for the wounded patient buried in earthquake(especially buried for long time) may be very important,the significant component of anesthesia should strengthen the monitoring and maintenance of vital organs such as heart and lung,the instability of haemodynamics in the critical patients would be contributed to the functional disorder of autonomic nerve after intensity stress.
引文
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[2]Charuluxananan S,Bunburaphong P,Tuchinda L,et al.Anesthesia for Indian Ocean tsunami-affected patients ata southern Thailand provincial hospital[J].Acta Anaes-thesiol Scand,2006,50(3):320.
[3]Katakami Y.Earthquake-induced stress:relationships andtrends noticed in health examination data from survivorsof the great Hanshin-Awaji earthquake(Jan.17,1995)[J].Rinsho Byori,1998,46(6):599.
[4]Huang JL,Chiou CW,Ting CT,et al.Sudden changes inheart rate variability during the 1999 Tai wan earthquake[J].AmJ Cardiol,2001,87(2):245.
[5]Lin LY,Wu CC,Liu YB,et al.Derangement of heart ratevariability during a catastrophic earthquake:a possiblemechanism for increased heart attacks[J].Pacing ClinElectrophysiol,2001,24(11):1596.
[6]Adachi K,Kawata M,Araki S,et al.Acase of Crush syn-drome with giant negative T waves and reversible leftventricular dysfunction[J].Jpn Circ J,1996,60(10):809.
[7]Ghodsi SM,Zargar M,Khaji A,et al.Chest injury in vic-ti ms of Bam earthquake[J].Chin J Traumatol,2006,9(6):345.
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