目的:分析胸腺瘤合并重症肌无力病人的麻醉管理。方法:对28例胸腺瘤合并重症肌无力病人麻醉进行回顾性分析,讨论该种病人的麻醉管理。结果:28例病人麻醉过程相对平稳,25例病人术后短时间拔管,麻醉后复苏室观察1-3 h 后送外科监护室观察1...目的:分析胸腺瘤合并重症肌无力病人的麻醉管理。方法:对28例胸腺瘤合并重症肌无力病人麻醉进行回顾性分析,讨论该种病人的麻醉管理。结果:28例病人麻醉过程相对平稳,25例病人术后短时间拔管,麻醉后复苏室观察1-3 h 后送外科监护室观察1-3 d,3例病人带管直接送外科监护室,24 h之内拔除了气管导管。无一例重症肌无力危象发生。结论:胸腺瘤合并重症肌无力病人需要术前认真准备,术中仔细操作避免大出血,应用平衡麻醉,术后加强监测能够有效防止重症肌无力危象的发生。展开更多
近年来加速康复外科(enhanced recovery after surgery,ERAS)在临床实践中作为外科发展的重要方向在国内外得到广泛应用。ERAS能够加快术后器官功能的恢复,减少并发症,缩短住院时间并降低医疗费用。胃癌根治术是治疗胃癌的主要手段之一...近年来加速康复外科(enhanced recovery after surgery,ERAS)在临床实践中作为外科发展的重要方向在国内外得到广泛应用。ERAS能够加快术后器官功能的恢复,减少并发症,缩短住院时间并降低医疗费用。胃癌根治术是治疗胃癌的主要手段之一,但存在手术刺激强,应激反应大的缺点,影响术后康复。目前,ERAS理念在胃癌根治术中的应用在不同地区有着较大差异,且由于ERAS理念的许多处理措施不同于传统方式,其安全性仍存在一定争议。本文就ERAS在胃癌根治术围术期麻醉管理中的应用进展进行综述。展开更多
Introduction: Perioperative hypothermia in cardiac surgery is associated with adverse outcome. The aim of this investigation was to study whether an underbody forced-air warming blanket during coronary artery bypass g...Introduction: Perioperative hypothermia in cardiac surgery is associated with adverse outcome. The aim of this investigation was to study whether an underbody forced-air warming blanket during coronary artery bypass graft surgery with normothermic cardiopulmonary bypass can prevent postoperative hypothermia. Methods: After Medical Ethics Committee approval, 60 low-risk cardiac surgery patients at random were assigned into a group that received standard thermal care management (control group n = 30) and a group that received the underbody forced-air warming system plus the standard thermal care (intervention group n = 30). Results: The temperature after-drop from the end of cardiopulmonary bypass to arrival in the ICU was less in the intervention group versus control group (0.4°C ± 0.3°C vs 0.6°C ± 0.4°C;P = 0.027). Out of the intervention group, 27 patients arrived in the ICU with a bladder temperature ? 36°C (90%) as compared to 14 patients (46.7%) from the control group (P < 0.001). The peripheral temperature was significantly higher in the intervention group as compared to the control group (P < 0.001). Conclusions: A full underbody forced-air warming blanket prevents postoperative hypothermia in normothermic coronary artery bypass graft surgery patients.展开更多
目的调查行全身麻醉患者围术期焦虑抑郁发生情况及其影响因素。方法选择北京大学第一医院2006年6—8月于全麻或全麻复合硬膜外麻醉择期手术的100例患者，于术前1d及术后5—10d访视，记录人口学及临床资料，嘱患者填写医院焦虑抑郁调查...目的调查行全身麻醉患者围术期焦虑抑郁发生情况及其影响因素。方法选择北京大学第一医院2006年6—8月于全麻或全麻复合硬膜外麻醉择期手术的100例患者，于术前1d及术后5—10d访视，记录人口学及临床资料，嘱患者填写医院焦虑抑郁调查量表（hospital anxiety and depression scale，HADS）。结果术前分别有23％，20％的患者存在焦虑、抑郁，术后分别为17％、16％。与术前焦虑相关因素为合并抑郁（P〈0．01）及中等（P〈0．05）或高等（P〈0．05）教育程度；与术前抑郁相关因素为合并焦虑（P〈0．01）；与术后焦虑相关因素为术前焦虑（P〈0．01），术后合并抑郁（P〈0．01）及低或中等教育程度（P〈0．05）；与术后抑郁相关因素为女性（P〈0．05）、术前抑郁（P〈0．01）、术后合并焦虑（P〈0．05）及术后咽部不适感（P〈0．05）。结论围术期患者可存在焦虑抑郁状态，两种负性情绪之间有明显相互影响，教育程度、性别和术后咽部不适感也可分别对围术期的情绪状态产生影响。展开更多
文摘目的:分析胸腺瘤合并重症肌无力病人的麻醉管理。方法:对28例胸腺瘤合并重症肌无力病人麻醉进行回顾性分析,讨论该种病人的麻醉管理。结果:28例病人麻醉过程相对平稳,25例病人术后短时间拔管,麻醉后复苏室观察1-3 h 后送外科监护室观察1-3 d,3例病人带管直接送外科监护室,24 h之内拔除了气管导管。无一例重症肌无力危象发生。结论:胸腺瘤合并重症肌无力病人需要术前认真准备,术中仔细操作避免大出血,应用平衡麻醉,术后加强监测能够有效防止重症肌无力危象的发生。
文摘近年来加速康复外科(enhanced recovery after surgery,ERAS)在临床实践中作为外科发展的重要方向在国内外得到广泛应用。ERAS能够加快术后器官功能的恢复,减少并发症,缩短住院时间并降低医疗费用。胃癌根治术是治疗胃癌的主要手段之一,但存在手术刺激强,应激反应大的缺点,影响术后康复。目前,ERAS理念在胃癌根治术中的应用在不同地区有着较大差异,且由于ERAS理念的许多处理措施不同于传统方式,其安全性仍存在一定争议。本文就ERAS在胃癌根治术围术期麻醉管理中的应用进展进行综述。
文摘Introduction: Perioperative hypothermia in cardiac surgery is associated with adverse outcome. The aim of this investigation was to study whether an underbody forced-air warming blanket during coronary artery bypass graft surgery with normothermic cardiopulmonary bypass can prevent postoperative hypothermia. Methods: After Medical Ethics Committee approval, 60 low-risk cardiac surgery patients at random were assigned into a group that received standard thermal care management (control group n = 30) and a group that received the underbody forced-air warming system plus the standard thermal care (intervention group n = 30). Results: The temperature after-drop from the end of cardiopulmonary bypass to arrival in the ICU was less in the intervention group versus control group (0.4°C ± 0.3°C vs 0.6°C ± 0.4°C;P = 0.027). Out of the intervention group, 27 patients arrived in the ICU with a bladder temperature ? 36°C (90%) as compared to 14 patients (46.7%) from the control group (P < 0.001). The peripheral temperature was significantly higher in the intervention group as compared to the control group (P < 0.001). Conclusions: A full underbody forced-air warming blanket prevents postoperative hypothermia in normothermic coronary artery bypass graft surgery patients.
文摘目的调查行全身麻醉患者围术期焦虑抑郁发生情况及其影响因素。方法选择北京大学第一医院2006年6—8月于全麻或全麻复合硬膜外麻醉择期手术的100例患者，于术前1d及术后5—10d访视，记录人口学及临床资料，嘱患者填写医院焦虑抑郁调查量表（hospital anxiety and depression scale，HADS）。结果术前分别有23％，20％的患者存在焦虑、抑郁，术后分别为17％、16％。与术前焦虑相关因素为合并抑郁（P〈0．01）及中等（P〈0．05）或高等（P〈0．05）教育程度；与术前抑郁相关因素为合并焦虑（P〈0．01）；与术后焦虑相关因素为术前焦虑（P〈0．01），术后合并抑郁（P〈0．01）及低或中等教育程度（P〈0．05）；与术后抑郁相关因素为女性（P〈0．05）、术前抑郁（P〈0．01）、术后合并焦虑（P〈0．05）及术后咽部不适感（P〈0．05）。结论围术期患者可存在焦虑抑郁状态，两种负性情绪之间有明显相互影响，教育程度、性别和术后咽部不适感也可分别对围术期的情绪状态产生影响。
