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目的探讨疑为动脉瘤性脑血肿脑疝患者急诊探查术的麻醉处理原则。方法我科与神经外科合作,采用静脉快速诱导气管插管、静吸复合维持麻醉的方法,对16例疑为动脉瘤性脑血肿脑疝行急诊探查术的患者进行了麻醉处理。术中监测ECG、IBP、HR、SpO2、CVP、PETCO2及尿量。结果 16例患者术后均证实为动脉瘤性脑血肿脑疝患者。全组患者均未行DSA或CTA检查,急诊手术清除血肿,探查并夹闭动脉瘤,麻醉过程顺利,无手术死亡病例。结论对疑为动脉瘤性脑血肿脑疝患者行急诊探查术时,需多学科的协作配合,快速平稳的麻醉诱导与维持、保障患者围术期生命体征的平稳、解除患者的颅内高压是抢救患者生命的关键。
Objective To investigate the principle of anesthesia in the emergency exploration of patients with suspected brain aneurysm cerebral hernia. Methods In cooperation with neurosurgery, 16 patients who underwent emergency exploration of intracerebral hernia with suspected aneurysm brain hematoma were anesthetized by intravenous rapid induction of tracheal intubation and static absorption combined with maintenance of anesthesia. Intraoperative ECG, IBP, HR, SpO2, CVP, PETCO2 and urine output were monitored. Results All the 16 patients were proved to be cerebral aneurysm in aneurysm cerebral hematomas. All patients did not perform DSA or CTA examination, emergency surgery to remove hematoma, exploration and clipping aneurysm, anesthesia was successful, no surgical deaths. Conclusions In the emergency exploration of patients with suspected intracranial aneurysm brain herniation, multidisciplinary coordination and rapid and steady anesthesia induction and maintenance are needed to ensure the perioperative vital signs are stable and the patient’s intracranial hypertension is relieved. The key to saving patient’s life.