唤醒麻醉在脑功能区病变切除术中的应用及护理

The clinical application and nursing cooperation of awaking anesthesia in neurosurgical treatment of brain lesions in functional cortex

目的探讨唤醒麻醉在脑功能区病变切除术中的应用及护理配合特点。方法对24例脑功能区占位病变病人进行喉罩插管、术中麻醉唤醒,在清醒状态下,通过皮质诱发电位及皮质电刺激等方法进行脑功能区定位,切除脑内病变后再在全麻下关颅。结果全部病例均在术中获得安全可靠麻醉唤醒,唤醒后脑功能区经采用神经电生理技术得到定位,脑内病变得到最大程度切除,术后出现神经功能障碍8例,其中7例为暂时性功能障碍,1例为永久性功能障碍。结论唤醒麻醉状态下切除脑功能区病变是安全、可行的,在术中结合皮质电刺激能最大限度切除病变,同时有利于脑功能的保护,减少术后并发症。高标准的护理配合是手术成功的重要保证。

Objective To evaluate the clinical application and intraoperative nursing cooperation of awaking anesthesia in surgical treatment of brain lesions in functional area. Methods 24 patients with brain functional area diseases underwent intertube mask and awaking anesthesia during operation. Under the awaking condition, the patients were applied to localize the functional cortex with cortical stimulation and cortical evoke potential methods. After lesion resection, general anesthsia was applied to patients again until wound closure. Results All patients underwent awaking anesthesia safely and functional cortexs were localized properly under the neurophysiology techniques. Lesions were resected in maximal extent. There are total 8 patients with neurofunctional impariments after operation, in which, 7 patients in temporary and one in permemet. Concision It is proved that awaking anesthesia is safe and applicable in brain lesion resection and useful in brain protection and complication control. Advanced nursing cooperation during operation is a key point for surgical intervention.