重症监护室在复合面部轮廓改型术后的监护作用

Function of ICU to supervise patients alter comprehensive correction of facial skeletal contouring

目的 探讨重症监护室（intensive care unit,ICU）在复合面部轮廓改型术后监护治疗中的重要性.方法 178例美容就医者术前行各项辅助检查,排除手术禁忌,均接受≥2项面部轮廓改型手术.麻醉拔管复苏后转入ICU监护.结果 26例（14.61%）术后出现低氧血症（SPO2≤90%）;11例（6.18%）低钾血症（K^＋≤3.5 mmol/L）;18例高血压（10.11%）;21例心律失常,其中15例（8.43%）心动过速（心率≥100次/min）,3例（1.69%）房性早搏,1例（0.56%）房颤,2例（1.12%）室性早搏;1例（0.56%）Ⅱ度房室传导阻滞;8例患者出现呼吸道梗阻;2例（1.12%）下颌部大出血,其中1例出血过多,输血600 ml;躁动17例（9.55%）;恶心呕吐65例.出现术后并发症者都进行了相应处理,无1例发生呼吸衰竭、失血性休克、心脏骤停等并发症.病情平稳后转回整形外科病房.结论 ICU能够对复合面部轮廓改型者术后进行及时、连续和系统的严密监护,有利于术后并发症的及时发现和紧急治疗.

Objective To investigate the function and necessity of ICU to supervise and cure the patients after comprehensive correction of facial skeletal contouring. Methods 178 patients were examined carefully and perfectly before operation to obviate taboo. After comprehensive correction of facial skeletal contouring operation, all the patients were transferred into ICU in order to be supervised and cured comprehensively. Results 26 （14. 61 %） patients had hypoxemia （ SPO2 ≤90 %）,11（6. 18 %）kaliopenia （K^＋≤3. 5 mmol/L） and 18 （10. 11 %） hypertension. 21 patients appeared arhythmia. Among these 21 arhythmia patients, 15 （8.43 %） patients had pyknocardia （HR≥100/min）, 3 （1. 69 %） atrial premature beat, 1 （0.56 %） fibrillation atrial, 2 （1. 12 %） premature ventricular contraction, 1 （0. 56 %） Ⅱ degree atrioventricular block. 8 patients had respiratory tract obstruction. 2 （1. 12 %） had hemorrhea of mandible and 1 transfused 600 ml blood. 17 （9. 55 %） patients had restlessness. 65 patients had nausea and vomitting. All patients in ICU having postoperative complications had been deal with corresponding management. There were no respiratory failure,hemorrhagic shock, cardiac arrest after operation in 178 patients. Conclusions ICU can offer timely, continuous, and systemic supervision and cure to patients after comprehensive correction of facial skeletal contouring,and reduce the postoperative emergency rate.