介入手术中麻醉管理

发布时间：2018-04-17 00:28

本文选题：介入放射学 + 麻醉　；参考：《介入放射学杂志》2015年09期

【摘要】：目的阐述介入手术中麻醉管理的重要性。方法回顾性分析2011年4月至2015年4月期间接受3、4级介入手术患者共24 382例,根据术中麻醉方式分为静脉全身麻醉联合喉罩或气管插管机械通气组(A组)、静脉全身麻醉自主呼吸组(B组)、清醒镇静组(C组)、局部麻醉组(D组)。监测4组患者术前、术中、术后心率(HR)、平均动脉压(ABP)、血氧饱和度(Sp O2)变化及麻醉相关并发症情况,并进行统计分析。结果 24 382例患者均按手术方案顺利实施麻醉,其中3级手术16 702例(68.5%),4级手术7 680例(31.5%);3级手术中A组6 797例(40.7%)、B组3 608例(21.6%)、C组5 095例(30.5%)、D组1 202例(7.2%),4级手术中A组4 193例(54.6%)、B组2 527例(32.9%)、C组699例(9.1%)、D组261例(3.4%)。各组患者术前HR、ABP与Sp O2差异无统计学意义(P0.05)。A、B、C组患者术中HR、ABP较术前差异无统计学意义(P0.05),组间比较差异无统计学意义(P0.05),Sp O2无明显改变(P0.05);D组患者术中HR、ABP较术前均有升高(P0.05),与其它3组比较存在统计学差异(P0.05),Sp O2无明显改变(P0.05)。D组中有22例患者因不能耐受而终止手术。结论在不同等级介入手术,尤其是3、4级介入手术中,针对患者不同病情和手术需要,选择个性化麻醉方案是手术安全、顺利、无干扰完成的重要保障,也是减少患者手术痛苦的良好途径,值得在介入手术中广泛推广应用。
[Abstract]:Objective to expound the importance of anesthesia management in interventional surgery.Methods from April 2011 to April 2015, 24 382 patients underwent 3 grade 3 or 4 grade interventional surgery were retrospectively analyzed.According to the anesthetic pattern, the patients were divided into three groups: general intravenous anesthesia combined with laryngeal mask or tracheal intubation mechanical ventilation group (group A), intravenous general anesthesia group (group B), conscious sedation group (group C), local anesthesia group (group D).The changes of heart rate (HRV), mean arterial pressure (ABP), blood oxygen saturation (SpO _ 2) and anaesthesia related complications were monitored in 4 groups before, during and after operation.Results 24 382 patients were anesthetized successfully according to the operation plan.There were 16 702 cases of grade 3 operation and 7 680 cases of grade 4 operation. Among them, 6 797 cases in group A (6 797 cases) and 3 608 cases in group B (3 608 cases) were treated with 3 095 cases of operation in group C and 3 095 cases in group D (1 202 cases of grade 7. 22 4). There were 4 193 cases in group A and 2 527 cases in group B and 2 527 cases in group C (group C). There were 699 cases in group D and 3. 441 cases in group D.There was no significant difference in preoperative HRABP and SPO _ 2 between each group. There was no significant difference in HRABP during operation between group A and P 0.05. There was no significant difference between group A and group A, there was no significant difference between group A and group A, there was no significant difference between group A and group B, there was no significant change in HRABP during operation in group P 0.05 and in group D, HRABP in group A was significantly higher than that in group D (P 0.05).Compared with the other three groups, there was no significant change of SPO _ 2 in P0.05 and SPO _ 2. In group D, 22 patients were terminated because of intolerance.Conclusion in different grade interventional surgery, especially 3 ~ 4 grade interventional surgery, according to the patient's different condition and the operation need, the choice of individualized anesthetic plan is an important guarantee for the operation safety, smooth and no interference to complete.It is also a good way to reduce the suffering of patients. It is worth popularizing in interventional surgery.
【作者单位】：贵州医科大学附属医院介入科;贵州医科大学附属医院麻醉科;
【分类号】：R614

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