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1病历简介例1:女,13岁,体重32kgo因剧烈活动后胸闷、胸痛、气短,其母发现患儿胸部正中凹陷来院就诊。入院诊断为漏斗胸,拟行带血管蒂胸骨翻转术。术前检查患儿营养发育中等。漏斗胸指数0.22,容量45ml。其他检查未发现明显异常。术前给予安定8mg,阿托品0.4mg。开放静脉,注射维库溴胺4mg,芬太尼0.1mg,异丙酚40mg,气管插管,接麻醉机控制呼吸,Vt320ml,f15次/min,I:E=1:1.5。术中间断静注芬太尼0.05mg,维库溴胺2mg,异丙酚20-30mg。术中SPO2维持在99%。行带血管蒂胸骨翻转术,术中出血约200ml,输浓缩红细胞1单元,输5%葡萄糖生理盐水1000ml。术中因双侧胸膜破裂行修补术,胸骨后放置胶管引流。手术结束时患儿苏醒,吸净分泌物,拔除气管导管,SPO290%-95%,护送回病房,继续鼻导管吸氧,SPO2始终在94%-95%,心率120次/min,术后第3天右胸腔穿刺抽出血性液体240ml,脱离吸氧后,SPO2维持在98%左右。术后15天痊愈出院。
1 case brief introduction Example 1: Female, 13 years old, weight 32kgo Due to intense chest tightness, chest pain, shortness of breath, his mother found the middle of the chest to the hospital for treatment. Admission was diagnosed as funnel chest, line vascularized sternotomy. Preoperative children with moderate nutritional development. Funnel chest index 0.22, capacity 45ml. Other tests found no significant abnormalities. Preoperative given stable 8mg, atropine 0.4mg. Open veins, vecuronium injection 4mg, fentanyl 0.1mg, propofol 40mg, tracheal intubation, anesthesia machine to control breathing, Vt320ml, f15 times / min, I: E = 1: 1.5. Intraoperative intermittent intravenous fentanyl 0.05mg, vecuronium 2mg, propofol 20-30mg. Intraoperative SPO2 maintained at 99%. Line pedicled sternotomy with blood vessels, intraoperative bleeding about 200ml, transfusion of red blood cells 1 unit, lose 5% glucose saline 1000ml. Surgery due to bilateral pleural rupture repair, drainage tube placed after the sternum. At the end of the operation, the patient was awakened, the net secretion was excreted, the endotracheal tube was removed, SPO290% -95%, escorted back to the ward, and the nasal catheter was continued to absorb oxygen. SPO2 was always at 94% -95% and heart rate was 120 beats / 3 days right pleural puncture bleeding liquid 240ml, out of oxygen, SPO2 maintained at about 98%. After 15 days cured.