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患者,男,11岁,口咬自制炸弹炸伤八小时入院。查血压3.99/2.66KPa,脉搏140次/分,呼吸22次/分,神清,表情淡漠,面色苍白,口周颌面软组织炸裂呈条索状悬垂,下齿龈与下颌骨分离,牙根外露,下颌骨在左下尖牙,右下第二乳磨牙两处骨折,关节正常,上腭、舌体多处裂伤,表面黑红色,口底浅层灼伤,整个创面污染严重。心肺(—)。麻醉会诊后拟定先抗休克治疗,待全身情况好转后在插管全麻下行口腔颌面部清创缝合,下颌骨钢丝内固定术。 1.麻醉处理:术前肌注适量阿托品、鲁米那。经积极抗休克血压回升至12/6.65KPa后入手术室,
Patient, male, 11 years old, bites a homemade bomb and was admitted to hospital for eight hours. Check the blood pressure 3.99 / 2.66KPa, pulse 140 beats / min, breathing 22 beats / min, Shen Qing, expression indifference, pale, perioral soft tissue bursts were cord-like drape, under the gum and mandibular separation, Mandible in the lower left canine, right lower second molars two fractures, normal joints, the palate, tongue, multiple lacerations, the surface black and red, shallow bottom mouth burns, the entire wound serious pollution. Cardiopulmonary (-). Anesthesia Consultation after the proposed anti-shock treatment, until the general condition improved after intubation anesthesia oral and maxillofacial debridement, mandibular wire fixation. 1. Anesthesia: Preoperative intramuscular injection of atropine, luminal. After active anti-shock blood pressure rose to 12 / 6.65KPa into the operating room,