【摘要】 目的 分析全麻后病人在麻醉恢复室(Post-anesthesia care unit,PACU)呼吸循环危急情况的发生情况,提出全麻恢复早期病人监护和护理的重要性。方法 回顾全麻后在PACU发生危急情况的病例2445例,总结处理经过和处理结果。结果发生呼吸循环等危急情况的病人共39例(发生率1.51％),其中发现严重低氧血症28例,严重低血压处理困难7例(其中伴有低氧血症2例)和严重高血压处理困难6例(其中伴有低氧血症1例),严重心律失常1例。由PACU再次转入手术室止血4例,均因发现及时抢救处理后转危为安。结论 全麻后的病人呼吸循环危急情况有一定的发生率,有必要在监测条件较好的PACU进行观察,以便早期发现和处理,可减少手术及麻醉的并发症和死亡率。更多还原

【Abstract】 Objective: To evaluate the importance of PACU monitoring and nursing by reviewing the incidence of critical events of the patients in PACU after general anesthesia. Methods 2445 patients wer reviewed. Critical events wase defined as severe desaturatin (Sa02 < 90 %), hypotension (SBP < 80mmHg), hypertension (SBP > 180mmHg) and severe arrthymia or bleeding. The treatment and outcome were Analyzed.Results Critical events were happened to 43 cases. That included 28 cases of elsvere desaturation. 10 of them had tracheal tube in place, 4 out of 10 had to restart mechanical ventilation, 18 out of the 28 cases were happened to the extubated patients. 4 of them were re -intubated. Severe hypotension unresponsive to fast fluid infusion were found in 7 cases (2 cases accompaning with hypoxemia), and severe hypertension resist to routine treatment were found in 6 cases(1 case accompaning with hypoxemia) . Severe arrthymia were happened to 1 case, which had AV block and severe bradycardia (HR = 31bpm) and ventricular paemature bigeminy. 4 cases of bleeding sent back for secrgical intervention. No anesthesia related death was founded. All critical events were found immediately in PACU and treated successfully. Conclusions Patients recoveing from general anesthesia are at risk of critical incidence. To improve patient safety, They should be monitored and observed in PACU carefully.更多还原