感染性休克患者的麻醉处理

目的 探讨感染性休克患者的麻醉处理经验.方法 选取2008年3月-2010年11月来医院急诊的感染性休克患者23例,均采用全身麻醉的方法且全程抗休克治疗；术前30 min肌内注射哌替啶、阿托品；依托咪酯、芬太尼用于麻醉诱导；异丙酚、羟丁酸钠用于麻醉维持,同时辅以小剂量的肌肉松弛药及氯胺酮；在手术的过程中监测患者的中心静脉压(CVP)、心电图(ECG)、血氧饱和度(SPO2)、血常规、尿量、血糖、有创动脉血压、乳酸水平、肾功、血气分析及电解质.结果 23例患者在手术前后生命指征具有明显的改善,比较差异有统计学意义(P＜0.05).结论 感染性休克患者的麻醉前准备、麻醉方法的选择、麻醉药物及剂量的选择为重点,同时,麻醉期间的管理、维持患者各脏器的功能及维持内环境等,也是影响麻醉是否成功的关键.

Anesthetic treatment for septic shock patients

OBJECTIVE To discuss the experience of anesthetic treatment for septic shock patients.METHODS Totally 23 patients with septic shock who enrolled in hospital from Mar 2008 to Nov 2010 were selected,all of them were treated with general anesthesia and the whole anti-shock therapy;23 cases were injected with pethidine and atropine 30 min before the operation;etomidate and fentanyl were used for the induction of anesthesia;propofol and sodium oxybate were for the maintenance of anesthesia,meanwhile,they were supplemented by small doses of muscle relaxants and ketamine;In the course of surgery the central venous pressure(CVP),electrocardiogram(ECG),oxygen saturation(SPO2),blood,urine,blood sugar,invasive arterial blood pressure,lactate levels,renal function,blood gas analysis and electrolyte of the patients were under surveillance.RESULTS The vital signs of 23 patients have improved significantly,the difference was statistically significant(P<0.05).CONCLUSION The preparation before anesthesia,selection of anesthesia approaches,the choice of anesthetic drugs and the doses are the key points of the septic shock patients,meanwhile,the treatment during anesthesia as well as the maintenance of the functions and organs and the inside environment is crucial to the anesthesia.