86例胸外伤急诊手术的麻醉处理

The Anesthesia of 86 Cases with Thoracic Injury in Emergency Surgery

目的分析胸外伤急诊手术的麻醉要点,总结其救治经验。方法对86例胸外伤行急诊手术的麻醉过程进行回顾性研究,探讨其致伤原因、伤情构成、麻醉选择及处理要点。结果顺利复苏出室75例,脱机困难转ICU9例(其中2例死于呼吸功能衰竭,2例死于合并的颅脑损伤,1例死于继发的多脏器功能衰竭),术中死亡2例。结论及时建立呼吸通道、选择适宜控制呼吸模式、维持循环功能稳定、密切注意合并伤、严格掌握拔管及转运指征、为术后治疗创造条件是其麻醉要点。

Objective To analyse the anesthesia points of chest trauma emergency surgery, sum up the experience of treatment. Methods 86 cases of thoracic trauma emergency surgery anesthesia were retrospectively analyzed to explore the reasons for trauma patients, the injured, anesthesia options and processing elements. Results 75 cases left the operating room after smoothly recovery, 9 cases that cannot he divorced from the ventilator transferred to intensive care unit（including two cases died of respiratory failure and two eases died of brain injury and one died of secondary multiple organ failure）, 2 cases died during surgery. Conclusion It is anesthesia elements that the timely establishment of respiratory channel, selected appropriate control ventilation, maintained the stability of circulatory function, to pay close attention to and deal with the merger injury, strictly indications of extubation and transit, to create conditions for the treatment of postoperative.