高龄心脏病患者行非心脏手术的麻醉处理

发布时间：2019-04-02 00:46

【摘要】：目的评价某院高龄心脏病患者行非心脏手术的麻醉处理效果,总结麻醉管理经验。方法 2014年1月至2015年1月,医院共处理高龄心脏病非心脏手术105例,择期手术者进行详细的术前处理,并制定麻醉管理方法,术中、术后强化监护标准,注重预防性用药减轻医源性操作刺激,稳定呼吸、循环。结果 24例急诊患者术前未做处理,术中发生不良事件4例、术后发生通气功能障碍7例、循环紊乱11例、中枢神经功能障碍6例,81例择期手术患者经预处理,各项指标为0、2、9、2例,择期手术者未见死亡例,急诊手术死亡1例;急诊者术后通气功能障碍、循环紊乱、中枢神经功能障碍发生率高于择期手术者,差异具有统计学意义(P0.05)。结论该院高龄心脏病患者行非心脏手术的麻醉处理效果较好,应注重择期手术术前预处理,控制危险因素,做好围术期监护、预防性用药。
[Abstract]:Objective to evaluate the anesthetic effect of non-cardiac surgery for elderly patients with heart disease in a hospital and summarize the experience of anesthetic management. Methods from January 2014 to January 2015, 105 elderly patients with non-cardiac heart disease were treated in the hospital. The patients undergoing selective operation were given detailed pre-operative management, and the methods of anesthesia management were worked out, and the monitoring standards were strengthened during and after operation. Attention should be paid to preventive use of drugs to alleviate iatrogenic operational stimuli, stabilize respiration, and circulation. Results 24 emergency patients had no treatment before operation, 4 cases had adverse events during the operation, 7 cases had ventilation dysfunction, 11 cases had circulatory disorder, 6 cases had central nervous dysfunction, 81 cases had been pre-treated, and the indexes were 0, 2, 2, 6, respectively. 9, 2 cases, no death was found in selective operation, 1 case died in emergency operation; The incidence of ventilatory dysfunction, circulatory disorder and central nervous dysfunction in emergency patients was higher than that in patients undergoing selective operation, the difference was statistically significant (P0.05). Conclusion the anesthetic treatment of elderly patients with heart disease in this hospital is better than that of non-cardiac surgery. We should pay attention to pre-treatment before selective operation, control the risk factors, do the perioperative monitoring well, and take preventive drugs.
【作者单位】：抚顺矿务局总医院麻醉科;
【分类号】：R614

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