尼泊尔地震救援中野外条件下的麻醉管理

目的：探讨地震救援野外条件下的麻醉管理特点和方法. 方法：救援现场行急症手术麻醉的56例伤员, 根据受伤程度、 手术类型采用个体化麻醉方式和心理干预. 结果：接受麻醉的56例伤员中,年龄最大的79岁,最小的8个月.麻醉的方法包括气管插管全身麻醉（3例）、丙泊酚静脉麻醉（18例）、神经阻滞（35例）.所有的伤员均达到满意的麻醉效果,大多数患者术中、术后生命体征平稳,均无严重并发症发生.结论：地震导致的伤害是多样的.地震伤员中以脱水、低血容量和挤压伤常见,为确保安全和减少并发症,术前予以充足的液体治疗至关重要.选用个体化的麻醉方式,加强围术期的管理,科学救治,充分发挥团队精神是地震伤员救治的根本保证.

Objective： To discuss the anesthesia management under field conditions after the Nepal earthquake. Methods： A total of 56 cases of earthquake victims who received emergency operations under anesthetic techniques according to the degree of injury, type of surgery and anesthesia using individual anesthetic and psychological intervention. Results： 56 patients receiving anesthesia aged 8 months t0 79 years old . The approach of anesthesia include general anesthesia （3 cases）, propofol intravenous anesthesia （18 cases）, nerve block （35 cases）. All the patients were satisfactory anesthesia, most patients were stable vital signs in operative a nd postoperative, there was no serious complications. Conclusion： Earthquake-related injuries are complex. In view of dehydration, hypovolaemia and crush injury are common in earthquake victims, it is essential to perform adequate fluid therapy preoperatively, to ensure safety and reduce complications. Choose individualized anesthesia, strengthening perioperative management and scientific rescue, give full play to the team spirit is the fundamental guarantee to treat the wounded.