颅脑外伤手术麻醉处理的临床体会

Clinical experience of anesthesia in craniocerebral trauma operation

目的:总结颅脑外伤手术麻醉处理经验。方法:2012年12月-2013年12月收治颅脑外伤患者76例,男46例,女30例,年龄13~77岁,平均55.5岁。疾病类型:硬膜下血肿11例,硬膜外血肿36例,颅内血肿25例,其他4例。所有患者均采用气管插管全身麻醉。结果:本组76例患者麻醉效果均满意,术毕意识障碍仍存在者3例,行气管切开或保留气管插管。其他73例患者麻醉诱导过程平稳,术毕能迅速恢复苏醒状态。本组术后有11例患者由于并发症严重,术后几日意识障碍仍存在。经过治疗,76例患者中发生肺部感染6例,死亡9例,病死率11.8%。结论:采用异丙酚、咪达唑仑、维库溴胺、芬太尼麻醉治疗颅脑损伤疗效显著,值得推广。

Objective:To summarize the experience of anesthetic in craniocerebral trauma operation.Methods:76 patients with craniocerebral trauma were selected from December 2012~December 2013.In 76 patients,46 cases were male,30 cases were female,aged 13~77 years old,and the average age was 55.5 years old.The type of the disease:11 cases with subdural hematoma,36 cases with epidural hematoma,25 cases with intracranial hematoma,4 cases with other type of craniocerebral trauma.All patients were treated with tracheal intubation general anesthesia.Results:76 patients were satisfied with the anesthesia effect,3 cases were still disturbance of consciousness after operation,then they were tracheotomy or tracheal intubation.Anesthesia induction were smoothly in other 73 patients,and they were recoved rapidly after operation.11 patients keep disturbance of consciousness for a few days after the surgery because of serious complications.In 76 patients,6 cases got pulmonary infection after treatment,9 patients died,the mortality was 11.8%.Conclusion:The curative effect of anesthesia treatment with propofol,midazolam,vecuronium bromide,fentanyl on craniocerebral injury is remarkable,it worthy of promotion.