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[术中危机与手术阿普加评分]

[Intraoperative crisis and surgical Apgar score].

作者信息

Oshiro Masakatsu, Sugahara Kazuhiro

出版信息

Masui. 2014 Mar;63(3):262-8.

Abstract

Intraoperative crisis is an inevitable event to anesthesiologists. The crisis requires effective and coordinated management once it happened but it is difficult to manage the crises properly under extreme stressful situation. Recently, it is reported that the use of surgical crisis checklists is associated with significant improvement in the management of operating-room crises in a high-fidelity simulation study. Careful preoperative evaluation, proper intraoperative management and using intraoperative crisis checklists will be needed for safer perioperative care in the future. Postoperative complication is a serious public health problem. It reduces the quality of life of patients and raises medical cost. Careful management of surgical patients is required according to their postoperative condition for preventing postoperative complications. A 10-point surgical Apgar score, calculated from intraoperative estimated blood loss, lowest mean arterial pressure, and lowest heart rate, is a simple and available scoring system for predicting postoperative complications. It undoubtedly predicts higher than average risk of postoperative complications and death within 30 days of surgery. Surgical Apgar score is a bridge between proper intraoperative and postoperative care. Anesthesiologists should make effort to reduce the postoperative complication and this score is a tool for it.

摘要

术中危机对麻醉医生来说是不可避免的事件。危机一旦发生就需要有效且协调的管理,但在极端压力情况下很难妥善处理危机。最近,在一项高仿真模拟研究中报告称,使用手术危机检查表与手术室危机管理的显著改善相关。未来,为了实现更安全的围手术期护理,需要进行仔细的术前评估、适当的术中管理并使用术中危机检查表。术后并发症是一个严重的公共卫生问题。它降低了患者的生活质量并增加了医疗成本。需要根据手术患者的术后状况进行仔细管理以预防术后并发症。根据术中估计失血量、最低平均动脉压和最低心率计算得出的10分手术阿氏评分,是一种简单且可用的预测术后并发症的评分系统。它无疑能预测出手术30天内高于平均水平的术后并发症和死亡风险。手术阿氏评分是术中与术后合理护理之间的桥梁。麻醉医生应努力减少术后并发症,而这个评分就是实现这一目标的工具。

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