109例重度颅脑损伤手术麻醉处理分析

Anesthesia use to Skull and Brain Severe Trauma Analysis of 109 Cases

重度颅脑损伤死亡率很高，积极手术、清除颅内血肿、减低颅内压、纠正休克是抢救病人的有效措施。而麻醉要给予密切配合，从术前准备，气管插管到术中循环和呼吸管理以及术后拔管，随访都要给予足够重视。采取科学态度，选用合适的降低颅内压的药物以及对循环呼吸影响小的药物和麻醉方法，尽量减少病死率，是麻醉的关键。

There wre 591 cases with skull/brain trauma having been treated in our hospital from 1984 to 1992. Among ofthem 109 cases(18% of all)were of severelyinjured patients according to the national criterion of severity of skull/brain trauma. In this article,we discussed the operations performed for those patients and a summary was made of after discussion We held that the mortality of such patient was rather high. But there were still some effective procedures such as to operate as early as possible, remove the intercraniolclot ,reducle the international pressure and tahe anti shock means etc all those wayssave the patiants life to some extent, if they were used welf.Besides,the anaesthesia should be coordinated closely with the operation,Beginning from the preparation of operation and racheal intubation to appropriate management of respiration and circulation during operation,as well as the removel of intulation and pcistoperation follow-upset,one word in the whele process of treatment adequate attention must be paid to all above mentioned procedure and the key measures of successful anaesthesia were the choices of suitable drugs to reduce intercranial pressure,the drugs and methds of anaesthesia with minimum adverse influenes on circulation and respiration in order to decrease the mortality。And it is also the Aim we have been persueing some effect way to reach。