【www.zhangdahai.com--入党自传】
[摘要] 目的:对OSAS患者全麻的安全性进行预测,以采取有效措施。方法:经过回顾性总结,掌握必要的预测方法和全麻诱导、插管、拔管安全措施。结果:103例OSAS全麻患者手术成功。结论:对OSAS患者只要注意到预测准确、措施得力、全麻诱导、插管、拔管及拔管后的治疗,安全性将大为提高。
[关键词] OSAS;全麻;安全性预测;措施
[中图分类号] R714.253 [文献标识码]A [文章编号]1674-4721(2010)03(a)-017-02
Security anticipate and measures of OSAS patients under general anesthesia
ZENG Zhaozhi
(Department of Anesthesiology, People′s Hospital of Linli County, Linli415200, China)
[Abstract] Objective: To expect the security of operation under general anesthesia to patients with obstructive sleep apnea syndrome(OSAS), and to take effective measures. Methods: Clinical data and experience were analyzed and summarized retrospectively. Necessary anticipation means and security measures including extubation under general anesthesia, induction, and intubation should be mastered. Results: 103 operations under general anesthesia were successful and all the patients with OSAS were safety. Conclusion: The security of induction, intubation and extubation under general anesthesia treatment has greater improvement, when correct and effective forecast measures is applied to OSAS patients.
[Key words] Obstructive sleep apnea syndrome(OSAS); General anesthesia; Security Anticipate; Measure
对OSAS(阻塞性睡眠呼吸暂停综合征)患者施行全身麻醉时关键在于通气供氧问题,临床上要做到正确预测和采取有效措施,才能提高患者安全性。笔者回顾性分析2 180例全麻患者,其中有103例为OSAS,占4.7%,麻醉处理经过顺利,现总结如下:
1 资料与方法
1.1 一般资料
OSAS患者103例,男58例,女45例,年龄28～72岁,体重49～91 kg,身高143～181 cm,ASAⅡ或Ⅲ级,有67例合并不同程度高血压、心肌缺血、心律失常、糖尿病,经治疗得到基本控制,手术历时40～180 min,其中,胃次全切手术5例,腹腔镜胆囊切除术88例,巨脾切除术2例,胆道探查8例。本组患者经病史采集和体格检查诊断为OSAS。
1.2 预测方法
预测患有OSAS的患者的气管插管困难,包括:①认真询问病史,了解患者身边的人,鼾声大、呼吸暂停次数较多、时间相对较长者;②体格检查发现超体重、头大颈短、张口较小、口型较小、头后仰受限、舌体胖大者;③用三角板法垂直测量甲颏距离
