经蝶入路垂体瘤切除术麻醉恢复期低氧血症的原因分析及护理

Cause analysis and nursing of postoperative hypoxemla in patients undergone transsphenoidal pituitary tumor resection of recovery from anesthesia

目的分析经蝶入路垂体瘤切除术后麻醉恢复期低氧血症的原因，并总结护理对策。方法回顾性分析579例经蝶垂体瘤切除手术患者的临床资料，对其低氧血症的发生原因及护理对策进行总结。结果579例患者中有30例术后发生低氧血症，发生率为5．2％。上呼吸道梗阻、喉及支气管痉挛、呼吸模式改变、肌肉松弛药的残余作用、术后麻醉药物的作用、误吸、急性肺水肿和术前肺部疾病等是引起低氧血症的主要原因。结论经蝶人路垂体瘤切除术后需严密监测，针对不同低氧血症的原因给予相应护理对策。

Objective To analysis causes and nursing strategies of postoperative hypoxemia in patients undergone transsphenoidal pituitary tumor resection. Methods 579 patients undergone transsphenoidal pituitary tumor resection were retrospectively investigated. Risk factors of postoperative hypoxemia and nursing strategies were analyzed. Results The incidence of hypoxemia was 5.2%. Upper airway obstruction, laryngospasm, bronchospasm ,change of breath pattern ,residual paralysis ,effect of narcotic drugs, aspiration ,acute pulmonary edema and lung disease were the main causes of postoperative hypoxemia. Conclusions Intensive care should be given to patients undergone transsphenoidal pituitary tumor resection and pertinent nursing strategies are the key to the prevention of postoperative hypoxemia.