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地震后颈椎损伤患者的麻醉处理
徐海涛,叶军青,王成才,刘虎,蒋京京,羊海琴,袁红斌*
0
(第二军医大学长征医院麻醉科,上海 200003)
摘要:
目的:总结地震所致颈椎损伤患者的麻醉处理经验。方法:回顾性分析我院麻醉科在汶川大地震中救治的6例颈椎损伤患者的围手术期麻醉管理资料,总结相关经验。结果:经过抗休克、稳定生命体征等处理后,6例伤员(3例野外条件下伤员采用慢诱导清醒盲探插管;3例后送至医院本部的伤员采用纤维支气管镜插管)在全麻下成功实施手术,术中呼吸、循环平稳,术后恢复良好。结论:野外条件下,清醒盲探插管是颈椎损伤患者的良好选择;在后方医院麻醉时气管插管宜选择颈椎活动小的纤维支气管镜插管。
关键词:  地震  颈椎损伤  麻醉  围手术期处理
DOI:10.3724/SP.J.1008.2008.00747
投稿时间:2008-07-01修订日期:2008-07-05
基金项目:
Anesthesia management of patients with cervical spine injury after earthquake
XU Hai-tao,YE Jun-qing,WANG Cheng-cai,LIU Hu,JIANG Jing-jing,YANG Hai-qin,YUAN Hong-bin*
(Department of Anesthesiology,Changzheng Hospital,Second Military Medical University,Shanghai 200003,China)
Abstract:
Objective:To summarize our experience on anesthesia management of patients who suffered from cervical spine injury after earthquake.Methods: The anesthesia management data of the 6 patients suffering from cervical spine injury during Wenchuan Earthquake (May 12,2008,China) were retrospectively analyzed.Results: After antishock treatment and stabilization of vital signs,the 6 patients underwent surgery under general anesthesia in an open field hospital (intubation was conducted with slow induction) or in our hospital (intubation was conducted with bronchofibroscope).During operation the patients showed smooth respiratory and cardiovascular characteristics,and recovered well after operation.Conclusion: Under the field condition,intubation with slow induction is a good choice for patients with cervical spine injury; while in a hospital,intubation with bronchofibroscope should be chosen because it causes less movement of cervical spine.
Key words:  earthquakes  cervical vertebrae injuries  anesthesia  peripoerative management