犬吸入麻醉的麻前准备的临床研究

发布时间：2018-04-20 11:16

本文选题：麻醉前准备 + 体况分析　；参考：《吉林大学》2017年硕士论文

【摘要】：近年来,由于国内宠物的饲养量逐年增加,宠物诊疗行业发展迅速,对现代兽医临床麻醉的要求也越来越高。麻醉师既要确保宠物在安全舒适的环境下顺利完成手术操作,还要在麻醉和手术中主动监测、调整和控制宠物的生理功能,防止并发症的发生,从而扩大了手术的适应症,降低了进行复杂手术宠物的死亡率。所以,这就要求了我们兽医工作者要对现在兽医麻醉技术进一步完善。而本文研究的就是在麻醉技术中相当重要的麻醉前准备及麻醉前对患病动物体况的评估与纠正。麻醉前准备包括对麻醉设备的准备,患病动物的麻前评估、体况纠正麻醉方案的选择等。麻醉前准备的是否完善直接决定着麻醉的成功与否,直接影响动物的生命。通过对动物身体状况的临床检查,来决定麻醉方案和给予用药。一个完整的麻前准备方案能减少动物在麻醉过程中出现的一些可以避免的致命因素。不同的动物需要视体况的差异进行不同的麻前准备。只有针对每一个患病动物制定属于它自己的麻醉前准备方案才能保证患病动物有更大的希望存活下来。本课题记录了吉林大学附属动物医院共187例手术病例,对这些病例进行统一的分析。71例病例需要术前纠正异常体况,占所有手术比例中的37.97%。21例生理手术未做术前检查,占11.23%。12例外伤处理未做术前检查,占6.42%。34例由于费用原因主人未做术前化验,占18.18%。在做完麻前评估与纠正后手术的病例,死亡率为1.89%。而未做麻醉前评估纠正的病例死亡率为6.17%。可见经过系统的麻前准备及体况评估纠正对降低动物的死亡率有相当重大的意义。在需要纠正体况的病例中,其中白细胞总数过高、酸碱平衡紊乱、脱水、贫血所占的比例相对较高。偶见肝肾功能异常、心肺功能异常及凝血异常等情况。上述71例病例需要进行体况纠正的病例中白细胞总数过高的病例有37例,占52.11%。白细胞总数过高主要见于机体炎症、急性感染、尿毒症、严重烧伤、急性出血、组织损伤等,通过抗生素的给与,可以适当纠正。酸碱平衡紊乱的有34例,占47.89%。最常见的是患病动物体内酸性物质产生过多或碱性物质丢失过多而引起的代谢性酸中毒,占所有酸碱平衡紊乱病例中的61.76%。在临床中通过碱性药物的给与,都起到了良好的纠正效果。脱水的病例有16例,占22.54%。临床上脱水主要见于呕吐、腹泻等大量体液丢失引起。通过合理的补充体液,脱水情况会很好的纠正。贫血的病例有19例,占26.76%。引起患病动物贫血的原因有很多,常见的为出血性贫血及溶血性贫血,偶见营养不良性贫血。严重贫血的病例通过输血纠正后再进行麻醉,麻醉风险大大降低。综上所述,本文旨在研究一个针对广大患病动物的系统的麻醉前准备方案,为兽医工作者及动物主人提供一个可参考的麻醉前指南。降低动物在手术过程中死亡的风险,推进宠物麻醉技术的发展。
[Abstract]:In recent years, as the raising of pets in China has increased year by year, pet diagnosis and treatment industry has developed rapidly, and the requirements for modern veterinary clinical anesthesia are becoming higher and higher. The anesthesiologist should not only ensure the smooth operation of pets in a safe and comfortable environment, but also monitor the animals in anesthesia and operation, adjust and control the physiological functions of pets and prevent the pets. The occurrence of complications increases the indication of the operation and reduces the mortality of the pet in the complex operation. Therefore, this requires our veterinarian to further improve the current veterinary anesthetic technique. This article is a study of the significant pre intoxication preparation in the anesthesia technology and the evaluation of the condition of the sick animals before anesthesia. Pre anesthesia preparation includes preparation of anesthetic equipment, pre anesthesia assessment of the sick animals, the selection of body condition and the selection of anesthetic schemes. The completion of pre anaesthesia directly determines the success of anesthesia directly affecting the life of animals. By clinical examination of the physical condition of animals, the anesthetic scheme and medication are determined. A complete preparedness plan can reduce some avoidable fatal factors in the process of anaesthesia. Different animals need to make different pre anesthesia preparations for the differences in body conditions. A total of 187 cases of surgical operations in the affiliated Animal Hospital of Jilin University were recorded. A unified analysis of these cases was carried out..71 cases needed to correct abnormal body conditions before operation, which accounted for 37.97%.21 cases in the proportion of all operations without preoperative examination, accounting for the exception of 11.23%.12 exceptions before operation, accounting for 6.42%.34 cases. The cause was not performed before the operation, and the 18.18%. was performed before the pre anesthesia evaluation and correction, the death rate was 1.89%. and the mortality rate corrected before anesthesia was 6.17%.. It was significant to correct the mortality of the animals by systematic pre anesthesia preparation and body condition assessment. Among the cases, the total number of white blood cells, acid-base balance disorder, dehydration, anemia accounted for a relatively high proportion. I see abnormal liver and kidney function, abnormal cardiopulmonary function and coagulation abnormality. In these 71 cases, there are 37 cases of high total white blood cells in the cases that need to be corrected in the case of body condition, accounting for the majority of the total 52.11%. white blood cells. Inflammation, acute infection, uremia, severe burns, acute bleeding, tissue damage, and so on, can be properly corrected through the administration of antibiotics. 34 cases of acid-base balance disorder are the most common in 47.89%., metabolic acidosis caused by excessive acid production or excessive alkaline substance loss in the body of the sick animals, which account for all acid-base levels. The 61.76%. in the disorder cases has been well corrected in clinical use of basic drugs. 16 cases of dehydrated cases, accounting for 22.54%. clinical dehydration, are mainly seen in vomiting, diarrhea and other loss of fluid. The dehydration can be corrected well through reasonable supplement of body fluid. 19 cases of anemia, accounting for 26.76%. There are many causes of anemia in sick animals, such as hemorrhagic anemia and hemolytic anemia, and Diaplastic anemia. The cases of severe anemia are anaesthetized after blood transfusion, and the risk of anaesthesia is greatly reduced. Veterinary surgeons and animal owners provide a reference anaesthetic guideline to reduce the risk of death during surgery and promote the development of pet anesthetic technology.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：S857.124

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