强热带风暴跨国医疗救援中麻醉与复苏工作的实践与展开

Practices of Anesthesia and Resuscitation in Transnational Emergent Medical Relief Following Cyclone Nargis

目的：探讨临床麻醉在紧急医疗救援中重要性及具体做法。方法：回顾总结参加“5·02”纳尔吉斯强热带风暴跨国医疗救援中麻醉和复苏工作展开的经验和体会。包括出发前的医务人员思想、技术和生活物资方面的准备。麻醉及相关设备，器械．物品和药物的准备。以及灾区在进行医疗救援中麻醉与复苏工作舶展开与实践等。结果：携带与麻醉相关的药物和耗材明显不合理；灾区12天共完成手术58例．局麻41例，静脉麻醉9例．区域阻滞8例，术后急性镇痛42人次，术后留观和输液治疗80余人次；手术患者多为受灾期间受伤后感染性／化脓性伤口甚至骨髓炎．及某些缺医少药未能得到治疗的外科疾病。结论：强热带风暴2周后赴灾区参加医疗救援时．麻醉和复苏工作的重点应围绕受灾期遭受各种创伤后未能得及时医疗而遗留下来急需外科处理感染性疾病展开．麻醉相关设备，物品．耗材和药品等的准备也才能做到有的放矢。

Objective： To explore the importance of anessthesia and resuscitation during emergent medical relief following Cyclone Nargis. Method： The experience and comprehension were retrospectively summarized in the transnational emergent medical relief following the ＂5·02＂ Cyclone Nargis. Result： There was a lot of irrationality in anesthesia-related drugs and consumed medical materials. Fifty-eight operations were completed during the period of distrass for 12d, including 41 cases of local anesthesia, 9 case of intravenous anesthesia, 8 cases of field block anesthesia, in which 42 cases of postoperative pain was intravenously relieved. The patients to be stayed and observed or to receive transfusion therapy had more than 80 person-time. The operated patients included cases with post-injury infective/purulent wounds or osteomyelitis during the period of Cyclone Nargis distrass, or with surgical illness that was gotten to be cured for the shortages of doctors and medicines. Conclusion： When emergent medical relief was needed to be attended after 2w of postdistrass, the focal points of anesthesia and resuscitation should rescue and care the patients with infective illness induced by diversed injuries subjected during the period of distrass but not to be gotten in time medical treatment and to need emergent surgical management. Therefore, the preparations of anesthesia-related equipment, items, comsumed medical materials, medicines and so on were albe to shoot the arrow at the target.