麻醉后监护室病人监测治疗应注意的问题(附2000例分析)

Problems on the monitoring treatment for the postanesthetic convalescents in postanesthesia care unit (Analysis of 2000 case)

目的 评价麻醉后监护室 ( post -anesthesiacareunit ,PACU)的重要意义。 方法 2 0 0 0例择期手术病人术后入PACU进行监测治疗 ,其中男性 10 75例 ( 5 3 .75 %)、女性 92 5例 ( 4 6.2 5 %) ,年龄 6个月～ 90岁 ,气管插管静 -吸复合麻醉 13 97例 ( 69.85 %)、全凭静脉麻醉 3 0 8例 ( 15 .4%)、硬膜外麻醉 15 7例 ( 7.85 %)、硬膜外阻滞复合气管内浅全麻 116例 ( 5 .8%)和神经阻滞麻醉 2 2例 ( 1.1%)。结果 病人在PACU留观时间 10min～ 3h不等 ,其中 10min～ 1h180 2例 ( 90 .1%)。 1968例 ( 98.4%)病人在PACU达到恢复标准后 ,转至病房 ,3 2例 ( 1.6%)重症病人保留气管导管送入重症监护病房 (ICU )继续监测治疗。监护期间常见并发症和意外主要有心律失常、低氧饱和度血症、恶心、呕吐、拔管后呼吸抑制和躁动等。结论 监护设备完善、急救物品齐全、医护人员高技术水平。

Objective To evaluate the important significances of monitoring therapy for the postanesthesia patients.Methods Of the 2000 selective postanesthesia patients,there were 1 075(53.75%) male and 925(46.25%) female with age rang from 6 Mo～90 y.Among patients,1 397 cases (69.85%) underwent intratracheal venous-inhalated anesthesia,308(15.4%) intravenous anesthesia,157(7.85%)epidural block anesthesia,116(5.8%) epidural block combined with light general anesthesia, and 22(1.1%) nervous block anesthesia.Results The stayed durations in PACU were 10 min～3 h in all patients, of them, 1802 cases (90.1%) within 10 min～1 h, 1968 cases (98.4%) in PACU returned to wards after a good recovery, and 32 cases (1.6%) were transferred to ICU for further monitoring because of critical conditions. The major complications and accidents during pestanesthetic monitoring treatment were arrhythmia, hypoxemia, PONV, respiratory depression and dysphoria after extubation, etc.Conclusion The pivotal factors to improve postanesthetic patients' prognosis in PACU are the perfect monitoring equipments, complete emergency agents, skillful technical staffs, standard managements, and so on.