【246】快点

【246】快点(第1/1页)

肌肉松弛会引起病人呼吸道问题,如痰堵等引发严重的患者窒息,因此要加上深度气道管理。

如此说来,病人一定得上气管插管了?

不一定,当下这手术是和大手术有区别的,大手术一大特性是时间长,当下这手术时间不长。

一个时间不长的手术你去给病人做气管插管,是挺费劲费力而且不讨好,原因在气管插管属插入技术难免会导致损伤让病人不舒服。

前文有讲过,以前气道管理是一定做气管插管,近现代伴随各式各样手术的全面开花麻醉学紧随蓬勃发展,麻醉医生们总结的经验越来越多,越敢采用丰富的技术手段减轻病人的痛苦。

因而要说到我们讲过的吼罩。

例如常见的乳腺妇科骨科等创伤小的手术,可以类比今天的手术了,同样要全麻但是时间短,可以用吼罩来代替气管插管。

当然技术超级厉害的麻醉医生,壮着有把握的技术胆子,采用十分娴熟的复合麻醉配比用药,在极短浅的全麻手术中直接用面罩做气道管理也有的。要做到这点,麻醉医生具体要再结合手术医生的需要和进度。

以上再归结起来是,伴随麻醉时间长短和深浅度,麻醉医生需要做的气道管理由浅入深:面罩,吼罩,气管插管。

三种方式的依次排列同时代表麻醉保障安全的从低到高,即气管插管是保证病人麻醉安全度最高的气道管理技术。

柳静云医生是从医经验不长,而且谁都知道她生性比较胆小,主张麻醉无小事只有大事必须把安全性放在最高位置上,因此给无论如何给病人上了吼罩。

道明这点是由于温“主刀”给她麻醉医生示意过了:手术时间绝对不会长。

于是祁医生此刻发现自己的说明只开个头,但是要赶不上“主刀”和助手的手术进程,急到一头汗往下说:“中医是有经络学的,经络学不同西医的解剖学,经络学里头讲疾病的气,郁结在经络里头得病,又可以相当于西医学里长了瘤体之类的病灶。瘤体肯定是全麻没法消除去的,等同于讲,全麻用药放在中医里头同样没法影响到气郁结成的病。”

旁边的人一边听祁医生马不停蹄的说,一边同祁医生一块紧张观望手术进程,产生与祁医生同样的焦虑:你能不能说快点,人家要干完活了?!

温“主刀”进针起针超快,没到一分钟,行针完毕。中间她究竟行针了几个穴位,做的是什么针法,现场围观的西医生们没一个人能看懂。

边要讲解的祁医生来不及细酌,只能说简明概要的:“她应该针的是腧穴。”

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