国际麻醉学与复苏杂志   2014, Issue (9): 11-11
    
地震伤员麻醉——雅安芦山地震与汶川地震比较
赵雨意, 左云霞1()
1.四川大学华西医院
The anesthesia of earthquake victims——a comparison between Ya'an Lushan-earthquake and Wenchuan-earthquake
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摘要:

目的 比较雅安芦山地震(Ya'an Lushan-earthquake, YLE)与汶川地震(Wenchuan-earthquake, WCE)伤员的麻醉特点,为提高地震救援麻醉水平提供经验。 方法 收集四川大学华西医院麻醉记录完整的YLE和WCE手术伤员相关资料,对比分析手术类型、患者病情、麻醉方法和术中及术后并发症等。 结果 YLE和WCE伤员手术量分别为225例和875例,手术类型以骨折切开复位内固定术为主(YLE 65.3%, WCE 41.7%),且WCE伤员截肢术远高于YLE伤员(11.8% vs 1.8%)。YLE伤员美国麻醉医师协会(ASA)分级Ⅰ级所占比例明显低于WCE伤员(4.4% vs 23.2%),而Ⅳ级伤员所占比例明显高于WCE伤员(8.0% vs 1.4%)。地震伤员麻醉以全身麻醉为主(YLE 92.9%, WCE 70.5%),YLE伤员椎管内麻醉所占比例更低(0.8% vs 13.2%)。地震伤员较常见的并发症是低血压(YLE 中28例, WCE 中73例)、低氧血症(YLE中1例, WCE中 42例)和返流误吸(YLE中0例, WCE中13例)。 结论 地震伤员手术以骨科手术为主,选择全身麻醉下手术较多,抢救过程中应加强低血压、低氧血症和返流误吸的防治。

关键词: 雅安芦山地震;汶川地震;麻醉
Abstract:

Objective To analyze the anesthesia characteristics of Ya'an Lushan-earthquake (YLE) and Wenchuan-earthquake (WCE) victims and provide experience for future medical care during disaster rescue. Methods Collecting related anesthesia information from medical records of surgeries performed for the victims during the two earthquake periods in West China Hospital, Sichuan University. The categories of surgery and anesthesia, patients' condition, intraoperative and postoperative complications were compared. Results Two hundred and twenty five surgeries during YLE and 875 surgeries during WCE were performed in West China Hospital. The main category of surgeries was open reduction and internal fixation(YLE 65.3%, WCE 41.7%). More amputations were carried out in WCE(11.8% vs 1.8%). The victims classified in ASAⅠ in YLE were fewer than those in WCE(4.4% vs 23.2%), while patients with the ASA IV were more in YLE(8.0% vs 1.4%). The main anesthesia method was general anesthesia during both earthquakes(YLE 92.9%, WCE 70.5%). Epidural anesthesia was performed less in YLE(0.8% vs 13.2%). The most common intraoperative complications were hypotension(YLE n=28, WCE n=73), hypoxemia (YLE n=1, WCE n=42) and aspiration(YLE n=0, WCE n=13). Conclusions The main category of surgeries for earthquake victims was orthopedics. Most surgeries were performed under general anesthesia. The earthquake victims were commonly followed by a variety of serious complications. Hypotension, hypoxemia and aspiration should be avoided during the rescue.

Key words: Ya’an Lushan-earthquake; Wenchuan-earthquake; Anesthesia