经蝶入路垂体瘤切除术麻醉恢复期低氧血症的防治

目的探讨经蝶入路垂体瘤切除术后患者麻醉恢复期低氧血症的发生原因及防治措施。方法回顾性分析2009年3月～2010年6月本院麻醉后恢复室(PACU)收治的579例经蝶垂体瘤切除手术患者的临床资料，对其低氧血症的发生原因及处理措施进行分析。结果579例患者中有30例术后发生低氧血症，发生率为5.2%。上呼吸道梗阻、呼吸模式改变、肌松残余作用、喉及支气管痉挛、术后麻醉药物的残余作用、误吸、急性肺水肿和术前肺部疾患等是引起低氧血症的主要原因。结论经蝶入路垂体瘤切除术后需严密监测、针对不同低氧血症的原因给予相应治疗。

Incidence and Prevention of Postoperative Hypoxemia in Transsphenoidal Pituitary Tumor Resection

ObjectiveTo observe the incidence and mechanism of postoperative hypoxemia in the patients after transsphenoidal pituitary tumor resection.Methods579 postoperative patients in postanesthesia care unit (PACU) in March, 2009～June, 2010 were investigated retrospectively using PACU databank. The incidence and mechanism of hypoxemia were analyzed.ResultsThe incidence of hypoxemia was 5.2%. Upper airway obstruction, change of breath mode, residual effects of anesthetics, bronchiospasm, aspiration, acute pulmonary edema and lung disease were the main reasons of postoperative hypoxemia after transsphenoidal pituitary tumor resection.ConclusionCareful monitor and treatment are the key to prevent hypoxemia after transsphenoidal pituitary tumor resection.