围生期新生儿急诊开胸手术的麻醉处理

目的探讨新生儿急诊开胸手术的麻醉与危症处理。方法对29例出生1周以内的新生儿急诊开胸手术的麻醉资料作回顾性分析。结果所有病例术前均有合并症,术中出现需要及时处理的并发症12例(41%),其中术中出现呼吸和心血管系统较大波动的有6例(20%),出现水电解质和酸硷失衡的有8例(27%),经对症处理术中得以纠正。术后有6例(20%)出现较严重肺部感染和不同程度心力衰竭,经抗感染、强心利尿和呼吸支持等治疗,得到控制。全部病例基本痊愈出院。结论并发症的严重程度对预后有直接影响。术中维持有效的呼吸道通气和较稳定的血流动力学,及时纠正水、电解质和酸碱失衡等并发症是麻醉成功的关键。

Anaesthesia of Perinatal Neonate Undergoing Emergency Chest Operation

Objective To study the anaesthesia of neonate undergoing emergency chest operation and the risk management. Method 29 cases of neonate undergoing emergency chest operation were retrospectively studied. Result All subjects had preoperative complications. 12 cases (41%) had complications and immediate treatment was required in the middle of operation. 6 cases (20%) had severe complications. All neonates were cured when discharged.Conclusion The severity of complications influenced the prognosis of the operation directly. The key of success is to maintain effective respiratory passage; respiratory tract venting and stable hemodynamics and to retrieve the balance of water-electrolyte and acid-alkali.