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目的 本文通过对84例喉癌手术病人切喉,颈清扫前后血压、心率变化的对比,提出在麻醉过程中的注意点。方法 全部病人选用局麻下气管造口后静脉复合全身麻醉。对呼吸道梗阻严重者气管造口前面罩吸氧,同时进行血氧饱台度监测。结果 全部病人切喉,颈清扫前后血压、心率变化统汁学比较P<0.01,有非常显著性差异,支持术中切喉,颈清扫时出现迷走神经反射及压迫颈动脉窦时出现不良反射,导致血压下降,心率减慢甚至心律失常。结论 根据上述情况可采用暂停手术数分钟,局部普鲁卡因封闭,充分供氧等方法都可消除不良神经反射,使病人顺利安全完成麻醉手术。
Objective To compare the changes of blood pressure and heart rate before and after laryngectomy and neck dissection in 84 patients with laryngeal cancer surgery and put forward the points of attention in the process of anesthesia. Methods All patients underwent local anesthesia with tracheal stoma intravenous compound anesthesia. Right respiratory tract obstruction in front of the tracheostomy mask oxygen, oxygen saturation at the same time monitoring stations. Results The blood pressure and heart rate before and after laryngectomy and before and after neck dissection in all patients were significantly lower than those in control group (P <0.01). There was a significant difference between the two groups in supporting the intraoperative laryngeal and neck dissection with vagal reflex and oppression of carotid sinus, resulting in Blood pressure, heart rate and even arrhythmia. Conclusions According to the above situation, it is feasible to use the method of suspending operation for several minutes, partial procaine closure, adequate oxygen supply and so on, so as to eliminate the bad nerve reflex and make the patient complete the anesthesia safely and safely.