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老年患者单纯腹部手术后的血气术后变化(作者译)

[Postoperative changes of blood gases after uncomplicated abdominal surgery in geriatric patients (author's transl)].

作者信息

Helms U, Weihrauch H, Jacobitz K, Steen L, Conrad I

出版信息

Prakt Anaesth. 1978 Aug;13(4):275-83.

PMID:693448
Abstract

In 34 elderly male and female patients undergoing upper abdominal surgery under general anaesthesia we investigated duration and degree of postoperative hypoxaemia. In this study only patients with no signs and symptoms of pulmonary or cardiac diseases, verified by normal lung function--vital capacity and FEV1, X-ray and electrocardiographic findings were considered. Postoperative development was free of complications and temperature rises in all cases. The investigations showed occurrence of arterial hypoxaemia during the postoperative period with values near the lower limit where the organism must fall back on cardio-circulatory reserve mechanisms in order to avoid general hypoxydosis. Regarding the restricted pulmonary and cardiac capacity for adaptation and compensation in geriatric patients, we recommend to prolong the practice of O2-application for two or three hours over a period of 24 to 48 hours, especially in patients with postoperative complications such as prolonged gastric atony, temperature, haemorrhage or cardiac and coronary insufficiency. This prolonged application of oxygen by mask or nasal tube should go parallel to other physiotherapeutic measures.

摘要

在34例接受全身麻醉下上腹部手术的老年男性和女性患者中,我们研究了术后低氧血症的持续时间和程度。在本研究中,仅考虑那些经正常肺功能(肺活量和第一秒用力呼气量)、X线和心电图检查证实无肺部或心脏疾病体征和症状的患者。所有病例术后病情发展均无并发症且体温未升高。调查显示,术后期间出现动脉低氧血症,其值接近下限,此时机体必须依靠心肺循环储备机制以避免全身低氧血症。鉴于老年患者肺部和心脏的适应及代偿能力受限,我们建议在24至48小时内将吸氧时间延长两到三个小时,尤其是对于有术后并发症(如胃瘫延长、发热、出血或心脏及冠状动脉功能不全)的患者。通过面罩或鼻导管延长吸氧应与其他物理治疗措施同时进行。

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