急症婴幼儿手术的麻醉处理

Anesthesia Management for Infant With a Surgical Emergency

目的探讨急症婴幼儿手术的麻醉方法及术中管理。方法187例中手术复杂性一般的腹部以下的患儿采用骶管麻醉,必要气管插管,一般状况较差的,术前有脱水酸中毒的以及涉及胸部手术的患儿采用气管内麻醉。2kg以下的采用T型管管理,2kg以上循环紧闭麻醉。结果术中有3例患儿发生返流。有7例患儿经皮血氧饱和度降到90%以下,经处理后改善。结论婴幼儿急症手术难度大,术前准备要充分,麻醉方法要恰当,加强术中管理。

Objective To explore the anesthesia technique and management during infant emergency operation.Methods 187cases were selected,the mild cases who underwent uncomplicated abdominal operation were treated with sacral anesthesia,added with tracheal cannula if it was necessary.While the severe cases who suffered from extreme dehydration acidosis or electrolyte disorder and the cases involving thoracic operation were treated with endotracheal anesthesia.The cases with body weight below2kg were concluded with T-piece,and the cases with body weight exceed2kg were concluded with circulation method.Results3cases were complicated with reflux.The oxygen saturation was decreased to below90%in7cases,but recovery after management.Conclusions It is difficult to deal with infant emergency operation,so it is necessary to have an adequate preoperative preparation,choose proper anesthesia method,as well as to reinforce the management during the operation.