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重度烧伤患者的麻醉(作者译)

[Anaesthesia for the severe burn patient (author's transl)].

作者信息

Nebel B, Hartung H J, Klose P, Osswald P M, Vossmann H

出版信息

Anaesthesist. 1980 Jul;29(7):353-9.

PMID:6999934
Abstract

By means of medical records, anaesthesia protocols and autopsy reports on 59 severely burnt patients of all age and risk groups, the three anaesthetic procedures mainly used in this group of patients-NLA, inhalation narcosis with halothane and Ketamine mono-anaesthesia-were retrospectively compared with regard to intra-operative complications and mortality. All the patients were in the initial phase of the treatment of burns, and had to undergo a variety of surgical interventions; these included changes of dressing, tracheotomy, necrotomy and skin grafts. Special pathophysiological problems of burns with particular consideration of the cardiocascular system, the lungs, the kidneys, and the electrolyte and acid-base balance are pointed out. Attention is drawn to the decisive importance of "preanaesthetic management" and to the specific technical problems of anaesthesia in patients suffering from burns. Each of the anaesthetic procedures discussed proved to be fundamentally suitable for the anaesthesia of persons suffering from very severe burns. Each of the anaesthetic procedures discussed proved to be fundamentally suitable for the anaesthesia of persons suffering from very severe burns. It should be left to the individual to decide which procedure in his experience should be preferred for a particular case.

摘要

通过查阅59名不同年龄和风险组别的严重烧伤患者的病历、麻醉方案和尸检报告,对该组患者主要使用的三种麻醉方法——神经安定镇痛术(NLA)、氟烷吸入麻醉和氯胺酮单一麻醉——在术中并发症和死亡率方面进行了回顾性比较。所有患者均处于烧伤治疗的初始阶段,必须接受各种外科手术干预;这些手术包括换药、气管切开术、坏死组织切除术和皮肤移植。文中指出了烧伤患者特殊的病理生理问题,尤其考虑了心血管系统、肺、肾以及电解质和酸碱平衡。文中还强调了“麻醉前管理”的决定性重要性以及烧伤患者麻醉的具体技术问题。所讨论的每种麻醉方法从根本上来说都适用于非常严重烧伤患者的麻醉。应该由个人根据自己的经验来决定在特定病例中哪种方法更可取。 所讨论的每种麻醉方法从根本上来说都适用于非常严重烧伤患者的麻醉。应该由个人根据自己的经验来决定在特定病例中哪种方法更可取。

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