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普通胸外科开胸手术中心脏骤停原因分析
http://www.100md.com 2009年2月5日 《中国实用医药》 2009年第4期
普通胸外科开胸手术中心脏骤停原因分析

     【摘要】 报导本院1985年6月至2006年12月,非外伤性普通胸外科手术中心脏骤停9例。其中发生于肺部手术4例,食管手术3例,纵隔肿瘤手术及胸内巨大良性肿瘤手术各1例。经积极处理,抢救成功9例,其中1例心肺复苏后脑水肿,术后遗留有精神症状,1例因术后再次出现心脏呼吸骤停死亡。通过对引起术中心脏骤停的主要因素回顾性分析,提高手术操作水平和技巧、树立联系的观点、在手术操作中要有对病变有动态认识,是防止手术中心脏骤停主要因素。麻醉的平稳,术中良好的监护在心脏骤停等意外事件中起到预防和早发现的作用。对高龄、合并基础病变、全身情况差的患者术前要加以调整,手术操作轻柔,加强术中监护,也是减少和预防普通胸外科手术中心脏骤停条件。

    【关键词】 心脏骤停;普通胸外科;手术中并发症

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    【Abstract】 The article reviewed 9 cases of cardiac arrest disease in the general thoracic surgery of our hospital from Jun.1985 to Dec.2006. All these patients, there were 4 cases with pulmonary carcinoma, 3 cases with esophageal carcinoma, 1 case with giant teratoma in the anterior mediastinum and 1 case with intrathoracic benign giant lipoma. Through actively management, all of the cases were resuscitated successfully. 1 case had mild psychiatric symptoms because of post-resuscitated brain edema. One case was dead of the second cardiopulmonary arrest after operation. The main elements that resulted in intraoperative cardiac arrest, through the retrospective analysis, come from prolonged operation and crude manipulation. Anesthetist could play a preventive role and early discover cardiac arrest in the accidental event. Paying more attention to the old men, correcting bad condition preoperatively, gentle manipulation, and enforced monitoring should be carried out to avoid cardiac arrest of the thoracic surgery. ......

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