胃食管反流患者麻醉手术中"哮喘"发作的应对措施

目的：总结胃食管反流病并发＂哮喘＂的患者在静脉麻醉下经食管射频治疗术和在全麻下腹腔镜胃底折叠手术中＂哮喘＂发作的应对措施。方法：对2008-01/2008-12 200例胃食管反流患者在静脉麻醉下行经食管射频治疗术（100例）和在全麻下腹腔镜胃底折叠术（100例）中的＂哮喘＂发作患者的处理进行总结。结果：射频治疗术有8例、胃底折叠术有28例患者发生不同程度的＂哮喘＂。处理措施均为静脉注射糖皮质激素和氨茶碱,胃底折叠术吸入七氟烷,呼吸机正压通气,以上措施无效者加用肾上腺素。结论：胃食管反流患者多有＂哮喘＂的呼吸道症状,是麻醉的危险因素之一,麻醉医师应高度重视,妥善处理。

Anesthesia Countermeasure of Patients with GastroesOphageal Reflux Combined with Asthma Attack

Objective：To explore the anesthesia countermeasure of asthma attack among the stretta radiofrequeney treatment under endoscope and laparoseopic nissen fundoplication（LNF） for patients with gastroesophageal reflux disease （GERD）. Methods ：Two hundred patients with GERD suffered from asthma attack were reviewed retrospectively who had been treated by the stretta radiofrequency treatment under endoscope with intravenous anesthesia （100 cases） and LNF with general anesthesia （100 cases） from January 2008 to December 2008. Results：8 patients among the stretta radiofrequency treatment under endoscope and 28 patients among LNF suffered from asthma attack. The countermeasure was intravenous glucocort/coid and aminophylline,sevoflurane inhalation,the mechanical ventilation with high positive and expiratory pressure（PEEP）. The patients with severe asthma attack could not be controlled add using epinephrine. Conclusions：Since patient suffer from GERD were subject to asthma attack,which is one of the risk factors to anesthesia. Anesthesiologists should focus on it and treat it in time.