全麻气管拔管后再次出现意识障碍的原因及处理

Tracheal tube after the causes and treatment of consciousness disorders

目的：探讨全麻气管拔管后再次出现意识障碍的原因。拟对后期及时正确的处理提供依据。方法：选择我院2007年1月～2012年1月外科手术52835例，其中静吸复合麻醉36985例，全静脉麻醉15850例，平均年龄（45±15）岁，病种有颅脑手术；颈胸部手术；腹部手术；泌尿外科手术；妇产、骨科等。麻醉平均时间（3±1）小时。对所有复苏后患者进行VAS评分；Ramsay评分；肌力评估取抬头30秒，握手有力等。评价标准：主要表现为意识再次障碍，Ramsay评分〉5分或不能唤醒。结果：52835例再次出现意识障碍的共21例，其中1例在转运途中，2例发生在病房，18例发生在麻醉恢复室。结论。再次出现意识障碍的原因为：一原发性基础疾病；二与麻醉或镇痛因素有关；三与各种刺激减弱有关。

Objective：Investigate anesthesia tracheal tube drawing appear again after the cause of the disturbance of consciousness. Plan to correctly handle the late timely provide a basis. Methods：Choose from 2007-2012 surgery in 52835 cases,including static suction compound anesthesia in 36985 cases , 15850 cases of total intravenous anesthesia, with an average age of （45 ± 15）, plants have craniocerebral operation; Neck chest surgery ; Abdominal surgery; Urinary surgery; Maternity, orthopedics, etc. Anesthesia average time （3 ± 1） hour. In all patients after recovery for VAS score; Ramsay score ; Strength assessment take up 30 seconds, shake hands strong, etc. The main performance evaluation standard for consciousness obstacle again, Ramsay score〉5 points or can＇t wake up. Results,52885 cases of consciousness appear again for a total of 21 patients with 1 case in transit,2 cases occurred in ward,eighteen cases happened in anesthesia recovery room. Conclusion： The cause of the disturbance of consciousness appear again for; a primary basic diseases ;2 and anesthesia or analgesia factors ; Three and various kinds of to stimulate the weakened.