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find Keyword "苏醒" 15 results
  • 无痛纤维支气管镜检查围手术期护理

    目的 总结无痛纤维支气管镜检查围手术期护理要点。 方法 对2011年11月-2012年5月行无痛纤维支气管镜检查的335例患者的围手术期护理方法进行回顾分析。 结果 335例患者均顺利完成检查,仅1例出现低氧血症但无麻醉意外发生,患者平均检查时间为(12.9 ± 2.27)min。 结论 采取积极有效的围手术期护理措施,能有效降低无痛纤维支气管镜检查患者围手术期相关并发症的发生率。

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  • Risk Factor Analysis of Delayed Recovery of Consciousness after Aortic Arch Surgery

    Objective To determine risk factors of delayed recovery of consciousness after aortic arch surgery underdeep hypothermic circulatory arrest (DHCA) and antegrade selective cerebral perfusion (ASCP). Methods We retrospectively analyzed clinical data of 113 patients who underwent aortic arch surgery under DHCA+ASCP in the Affiliated Drum Tower Hospital, Medical School of Nanjing University from October 2004 to April 2012. According to whether they regained consciousness within 24 hours after surgery, all the 113 patients were divided into normal group (73 patients including 55 males and 18 females with their average age of 48.1±10.9 years) and delayed recovery group (40 patients including 29 males and 11 females with their average age of 52.2±11.4 years). Risk factors of delayed recovery of consciousness after surgery were evaluated by univariate analysis and multivariate logistic regression analysis. Results Nine patients (8.0%) died postoperatively, including 5 patients with multi-organ failure, 2 patients with heart failure, 1 patient with mediastinal infection, and 1 patient with pulmonary hemorrhage. There were 7 deaths (17.5%) in the delayed recovery group and 2 deaths (2.7%) in the normal group, and the in-hospital mortality of the delayed recovery group was significantly higher than that of the normal group (P=0.016). A total of 94 patients (including 65 patients in the normal group and 29 patients in the delayed recovery group) were followed up for 4-95 months. Eight patients (including 5 patients in the normal group and 3 patients in the delayed recovery group) died during follow-up, including 2 patients with stroke, 3 patients with heart failure, 2 patients with pulmonary hemorrhage and 1 patient with unknown cause. Ten patients were lost during follow-up. Univariate analysis showed that age (P=0.042), hypertension (P=0.017), emergency surgery (P=0.001), cardiopu- lmonary bypass (CPB) time (P=0.007), aortic cross-clamp time (P=0.021), and blood transfusion(P=0.012)were risk factors of delayed recovery of consciousness after aortic arch surgery. Multivariate logistic regression showed that emergency surgery (P=0.005) and CPB time>240 minutes (P=0.000) were independent risk factors of delayed recovery of consciousness after aortic arch surgery. Conclusion Delayed recovery of consciousness after aortic arch surgery is attributed to a combination of many risk factors. Correct patient diagnosis, lesion site and involved scope should be made clear preoperatively in order to choose appropriate surgical strategies. During the surgery, strengthened brain protection, shortened operation time, improved surgical techniques, and perioperative stable circulation maintenance are all important measures to prevent delayed recovery of consciousness after aortic arch surgery.

    Release date:2016-08-30 05:45 Export PDF Favorites Scan
  • 麻醉苏醒期高血压患者的临床观察及护理

    目的 分析麻醉苏醒期患者出现高血压的原因,并采取相应的观察护理措施。 方法 回顾性分析2012 年4 月-7月进入麻醉苏醒室的5 005例患者,记录出现高血压患者的临床资料。 结果 麻醉苏醒期发生高血压患者184例(3.7%),其中既往有高血压病史的患者105例(56.8%),无高血压病史的患者79例(43.2%);使用镇痛药者42例(23.2%),未使用镇痛药者142例(76.8%);使用降压药者93例(51.7%),未使用降压药者91例(49.3%);发生高血压给予处理后观察20 min,其收缩压和舒张压与未处理前比较有统计学差异(P<0.05)。 结论 及时有效的分析麻醉复苏期间患者发生高血压的原因,给予及时的镇痛和降压处理,能有效改善患者的血压,保证患者麻醉复苏期间的安全。

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  • 无痛胃镜下行食管静脉曲张套扎术后患者麻醉苏醒期的护理

    【摘要】 目的 总结对无痛胃镜下行食管静脉曲张套扎术患者麻醉苏醒期的护理要点。 方法 2009年3月-2009年10月,对83例食管静脉曲张患者在无痛胃镜下行曲张静脉套扎术,术后麻醉苏醒期采取密切观察、积极预防、及时处置等有效护理措施,防止并发症发生。 结果 麻醉苏醒期,有7例患者出现低氧血症,1例出现反流但无误吸。 结论 积极有效的护理措施,能有效降低无痛胃镜下食管静脉曲张套扎术患者麻醉苏醒期相关并发症的发生率。

    Release date:2016-09-08 09:26 Export PDF Favorites Scan
  • 全身麻醉后苏醒患者躁动原因的分析及护理对策

    【摘要】 目的 分析全身麻醉患者苏醒期发生躁动的原因,提出相应的护理对策。 方法 回顾性分析2008年10月-2009年10月收治的148例全身麻醉患者的临床资料,分析39例患者发生躁动的原因,并加以预防。 结果 148例全身麻醉患者中有39例发生躁动,发生率为26.35%。用纳洛酮催醒患者躁动的发生率为48.6%(36/74),明显高于自动清醒患者4.1%(3/74),两者躁动发生率比较有统计学意义(χ2=37.9139,Plt;0.001)。 全身麻醉患者的躁动发生率为35.3%(36/102),高于全身麻醉复合硬膜外阻滞麻醉患者6.5%(3/46),两者躁动发生率比较有统计学意义(χ2=8.1369,Plt;0.001)。 结论 疼痛、促醒、导管刺激为常见躁动原因;掌握全麻患者苏醒期躁动的原因,加强护理,确保患者安全渡过麻醉苏醒期,可以防止躁动所致伤害的发生。

    Release date:2016-09-08 09:51 Export PDF Favorites Scan
  • Comparison between Sufentanil and Fentanylon Their Clinical Effect in Neurosury

    目的:比较舒芬太尼与芬太尼复合七氟烷麻醉在神经外科手术中对血流动力学、拔管时间、苏醒时间及术后疼痛情况的影响。方法:择期开颅手术患者60例,随机分为舒芬太尼(S)组和芬太尼(F)组,每组30例。将S和F的效能比定为10:l,复合咪唑安定、维库溴胺、异丙酚来进行麻醉诱导;麻醉维持均复合七氟烷。分别记录麻醉前、诱导后、插管时和拔管时血压和心率变化;呼吸恢复、睁眼和拔管时间以及拔管后半小时疼痛评分(VAS评分)。结果:两组麻醉诱导后收缩压(SBP)、舒张压(DBP)、心率(HR)均较诱导前有显著性下降(Plt;0.05)。F组插管及拔管时,血流动力学变化均较S组有显著性升高(Plt;0.05)。S组苏醒期呼吸恢复、睁眼、拔管时间较F组明显缩短;拔管后半小时疼痛评分(VAS评分)S组低于F组。结论:与芬太尼相比,等效剂量的舒芬太尼用于脑外科手术患者麻醉诱导可更有效地减轻全麻诱导气管插管时的心血管反应;在麻醉苏醒期,更有利于呼吸管理及术后镇痛。舒芬太尼在神经外科麻醉中具有很好的临床应用价值。

    Release date:2016-09-08 10:02 Export PDF Favorites Scan
  • 神经外科麻醉苏醒室的呼吸道管理和护理体会

    目的探讨神经外科麻醉苏醒室(N-PACU)麻醉苏醒期呼吸道管理及呼吸系统并发症的护理。 方法对2012年1月-2013年5月行颅脑神经外科手术的2 231例患者带气管导管术毕返回N-PACU进行观察记录,对麻醉苏醒期间出现的各种呼吸系统并发症及护理方法进行分析。 结果在麻醉苏醒期出现了124例低氧血症,发生率约为5%,所有患者经积极处理后均安全返回病房,无患者死亡。 结论N-PACU医护人员的谨慎观察和及时处理是保障患者安全渡过麻醉苏醒期的重要保障。

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  • 麻醉苏醒期血流动力学并发症的观察

    目的观察麻醉苏醒室(PACU)患者血流动力学并发症的发生率,及时纠正患者的高血压、低血压及心律失常等。 方法2012年7月-11月对全身麻醉手术后入PACU的8 440例患者资料进行回顾性统计,分析血流动力学并发症的发生率。 结果术后麻醉苏醒期高血压的发生率为4.6%(388/8 440),低血压的发生率为0.3%(22/8 440),心律失常的发生率为1.1%(89/8 440)。 结论对入PACU的患者应进行全面评估并在PACU期间严密观察患者的病情变化,以减少PACU并发症的发生,保证患者在PACU期间的安全复苏。

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  • Observation and Nursing of Hypotension for Patients during Anesthesia Recovery Period

    ObjectiveTo observe the incidence of hypotension in general anesthesia patients in post anesthesia care unit (PACU), compare the blood pressure before and after treatment, and analyze hypotension causes. MethodBetween September 2012 and July 2013, data of 18 931 patients in PACU after general anesthesia were retrospectively analyzed for the incidence of hypotension. At the same time, the change of blood pressure was also detected before and after treatment. ResultsSixty-two patients had hypotension during the anesthesia recovery period after general anesthesia. The incidence was 0.33%. The proportion was the highest among patients who underwent abdominal surgery, reaching 41.9%. Systolic pressure and diastolic pressure improved significantly after treatment (P<0.05). ConclusionsIt is important to perform comprehensive evaluation of vital signs, closely observe disease conditions and vital sign changes, find out and manage low blood pressure for patients in PACU, which secure their safety.

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  • 全身麻醉术后患者麻醉苏醒期寒颤的观察及护理干预

    目的观察全身麻醉术后患者在麻醉苏醒室(PACU)寒颤的发生率,及时纠正患者的寒颤,以保证其平稳渡过麻醉苏醒期。 方法回顾性分析2012年9月-2013年7月18 931例全身麻醉术后入PACU的患者的寒颤发生率、寒颤与手术部位的相关性,分析采用调高室温、使用棉被及保温毯、大量输血输液时使用加温器等护理干预措施后的效果。 结果18 931例麻醉苏醒期患者中发生寒颤124例,发生率为6.55‰;其中腹部手术患者最多,占33.87%。以腹部、脊柱手术寒颤发生率最高,为8.87‰和7.30‰。给予护理干预及用药30 min后102例患者寒颤缓解,缓解率为82.25%。 结论应对入PACU的患者进行全面评估并在PACU期间进行密切监护,及时发现术后寒颤,采取积极治疗和护理干预措施,使患者平稳、安全地渡过麻醉苏醒期。

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