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2008年中国汶川地震伤的麻醉管理

Anesthetic management of injuries following the 2008 Wenchuan, China earthquake.

作者信息

Wang Z, Sun Y, Wang Z, Wang Q, Yu W

机构信息

Department of Anesthesia, Eastern Hepatobiliary Surgery Hospital, 225# Changhai Road, Shanghai, 200438, China.

, 9# Huafeng Residential Quarter, Jiangyou, Sichuan, 621700, China.

出版信息

Eur J Trauma Emerg Surg. 2011 Feb;37(1):9-12. doi: 10.1007/s00068-010-0021-1. Epub 2010 May 4.

DOI:10.1007/s00068-010-0021-1
PMID:26814745
Abstract

PURPOSE

The authors report anesthetic considerations and management of injuries after the 2008 Wenchuan earthquake, Sichuan, China.

METHODS

Medical records of surgical patients cared for by the seventh medical team of the Second Military Medical University and the Jiangyou 903 Hospital in the 2008 Wenchuan, China earthquake were reviewed retrospectively with respect to injury patterns, preoperative evaluation, anesthetic techniques, anesthetic management and postoperative recovery.

RESULTS

Of 908 patients who were triaged over 2 weeks, 372 (41.0%) patients required admission, of whom 231 (62.1%) patients were managed non-surgically and the remaining 141 (37.9%) patients required emergency surgery under anesthesia. Of the 141 patients, general anesthesia was performed in 16 (11.3%) patients, epidural anesthesia in 55 (39.0%) patients, brachial plexus block in 25 (17.7%) patients, cervical plexus block in seven (5.0%) patients, and monitored anesthesia care in 38 (27.0%) patients. No spinal anesthesia was used in these patients. Minor complications including hypotension, tachycardia and bradycardia were noticed and treated immediately. No severe complications occurred, such as cardiorespiratory arrest, inadvertent intravascular injection, pneumothorax or total spinal anesthesia.

CONCLUSION

Epidural anesthesia and peripheral nerve block are the anesthetic techniques of choice for post-earthquake injuries due to limited conditions and appliances. More attention should be paid to preoperative evaluation, anesthetic techniques, anesthetic management, anesthetic application and postoperative recovery according to patient conditions and the limited environment.

摘要

目的

作者报告了对2008年中国四川汶川地震后受伤患者的麻醉考虑及处理。

方法

回顾性分析了第二军医大学第七医疗队和江油903医院在2008年中国汶川地震中救治的外科患者的病历,内容包括损伤类型、术前评估、麻醉技术、麻醉管理及术后恢复情况。

结果

在2周内接受分诊的908例患者中,372例(41.0%)需要住院治疗,其中231例(62.1%)接受非手术治疗,其余141例(37.9%)需要在麻醉下进行急诊手术。在这141例患者中,16例(11.3%)实施全身麻醉,55例(39.0%)实施硬膜外麻醉,25例(17.7%)实施臂丛神经阻滞,7例(5.0%)实施颈丛神经阻滞,38例(27.0%)实施麻醉监测管理。这些患者均未使用脊髓麻醉。注意到并立即处理了包括低血压、心动过速和心动过缓在内的轻微并发症。未发生严重并发症,如心肺骤停、意外血管内注射、气胸或全脊髓麻醉。

结论

由于条件和设备有限,硬膜外麻醉和周围神经阻滞是地震后损伤的首选麻醉技术。应根据患者情况和有限的环境,更加关注术前评估、麻醉技术、麻醉管理、麻醉应用及术后恢复。

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本文引用的文献

1
The injury profile after the 2008 earthquakes in China.2008年中国地震后的损伤情况。
Injury. 2009 Jan;40(1):84-6. doi: 10.1016/j.injury.2008.08.045. Epub 2008 Dec 30.
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Ketamine.氯胺酮
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Lancet. 2001 Aug 18;358(9281):590. doi: 10.1016/S0140-6736(01)05739-7.
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