42例麻醉期间心跳、呼吸骤停的原因与救治

目的 探讨麻醉期间心跳、呼吸骤停的常见原因与抢救方案.方法 对麻醉期间42例患者心跳、呼吸骤停的可能原因和复苏方法进行回顾性分析.结果 心跳、呼吸骤停的主要原因依次为缺氧(19.1%),失血性休克、低血压(16.7%),高血压心肌缺血(11.9%),迷走神经反射(9.5%),低血钾(7.1%);42例心跳、呼吸骤停患者,12例早期死亡,30例心脏复苏,24例脑复苏未留任何后遗症,抢救成功率为57.1%;在抢救过程,出现上消化道出血18例,呼吸衰竭7例,急性肾功能衰竭2例,4例患者死于多器官功能障碍.结论 麻醉期间缺氧和大出血是心跳、呼吸骤停的重要原因,正确的复苏方法加上并发症的防治可提高复苏成功率.

Causes and treatment of cardiac-respiratory arrest during anesthesia:an analysis of 42 cases

Objective To explore the common causes and rescuing scheme of cardio-respiratory arrest.Methods The possible causes and resuscitation mode of 42 patients with cardio-respiratory arrest during anesthesia were analyzed retrospectively.Results The main causes of cardio-respiratory arrest were hypoxia(about 19.1%),hemorrhagic shock and hypotension(about 16.7%),hypertension with myocardial ischemia(11.9%),vagus reflex(9.5%),and hypopotassemia(7.1%) in turn.In 42 patients,12 patients were early death,30 patients were resuscitation of heart,but 24 patients were resuscitation of brain with no sequela,the rescuing achievement ratio was 57.1%.During salvage,18 patients suffered from upper gastrointestinal bleeding,7 cases with respiratory failure,2 cases with acute renal failure and 4 patints succumbed to multiple organ dysfunction.Conclusion Hypoxia and hemorrhea might be the important reasons of cardio-respiratory arrest during anesthesia,perfect rescuing mothods plus prevention and cure of complications should be able to improve the rescuing achievement ratio.