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[经腹分娩麻醉的并发症及特殊性]

[Complications and peculiarities of anesthesia in abdominal delivery].

作者信息

Balich E Ia

出版信息

Anesteziol Reanimatol. 1993 Jan-Feb(1):51-5.

PMID:7943866
Abstract

Analysis of the reasons responsible for complications of anesthesia in abdominal delivery has shown that such complications are most frequent before fetus extraction. They are: poorly corrected hypo- or hypertension and tachycardia; damages of major vessels, pleura and lungs upon central vein puncture; severe hypoxia in difficult or abortive intubations with mouth, larynx, pharynx, trachea and esophagus injuries; regurgitation and development of aspiration pneumonia (Mendelson syndrome); toxic and allergic reactions to psychopharmacological, narcotic and local anesthetic agents; signs of laryngobronchiolospasm; complications during suture of the uterus and abdominal cavity when main anesthesia is performed (hypotonic bleeding with the onset of ARDS, hemodynamic disturbances due to microembolism of the pulmonary artery branches upon active contractions of the uterus caused by uterotonics, side effects of myorelaxants); complications in the early postoperative period (prolonged apnea, the onset of acute cardiopulmonary and hepatic failure).

摘要

对剖宫产麻醉并发症原因的分析表明,此类并发症在胎儿娩出前最为常见。它们包括:未得到有效纠正的低血压或高血压以及心动过速;中心静脉穿刺时主要血管、胸膜和肺部的损伤;困难或失败插管时严重缺氧并伴有口腔、喉部、咽部、气管和食管损伤;反流及吸入性肺炎(门德尔松综合征)的发生;对精神药理、麻醉和局部麻醉药物的毒性及过敏反应;喉支气管痉挛体征;在实施主要麻醉时子宫和腹腔缝合过程中的并发症(发生成人呼吸窘迫综合征时的低张性出血、宫缩剂引起子宫主动收缩导致肺动脉分支微栓塞引起的血流动力学紊乱、肌松剂的副作用);术后早期并发症(呼吸暂停延长、急性心肺和肝衰竭的发生)。

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