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Postoperative Respiratory Care On Oral And Maxillofacial Surgery

口腔颌面外科术后呼吸护理

基本信息

批准号：
05454548
负责人：
AMEMIYA Yoshihiro
金额：
$ 4.16万
依托单位：
Tsurumi University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1993
资助国家：
日本
起止时间：
1993 至 1994
项目状态：
已结题

项目摘要

In recent years, more patients than previously are at risk for postoperative respiratory complications because of the prolonged time required for oral and maxillofacial operations and the increasing number of elderly patients. The inclusion of the trachea in the operative field can lead to postoperative respiratory complications, even in patients with no respiratory impairment before operation. However, we have found no report describing criteria for the management of postoperative respiratory function in this field.We sought to obtain a better understanding of the current status at dental colleges and dental school hospitals and to study optimal methods for the management of respiratory function after oral and maxillofacial surgery, thereby improving our ability to predict and prevent postoperative respiratory comlpications.A total of 92.3% of the dental colleges and dental school hospitals responded that postoperative patient management was performed by a dental anesthesiologist. Ama … More ng patients receiveing general anesthesia, 4.3% were anesthetized for prolonged periods of 10 or more hours ; virtually all of these patients underwent surgery for malignant tumors. However, few institutions had guidelines for postoperative respiratory management, and less than half had an artificial respirator.At our hospital, about 4.8% of patients undergo prolonged anesthesia. About 97% of these patients are at increased risk for suffering some postoperative respiratory complication, when assessed aqccording to the scoring system for the prediction of postoperative respiratory complications established by Okutsu et al. In fact, however, no serious complications developed in any patient. Such complications were apparently prevented by postoperative respiratory management with an artificial respirator. Patients who undergo prolonged anesthesia therefore require propgylactic artificial respiration for a minimum of 24 hours after operation. Impaired respiratory function was especially present in elderly patients, who had a high incidence of postoperative respiratory complications even if they did not undergo prolonged operations. Postoperatively, tidal volume was lower than before operation, and a decrease in postoperative vital capacity of * 30% was considered an indication for prophylactic artificial ventilation. Less

近年来，由于口腔颌面部手术所需时间的延长和老年患者的增加，术后呼吸系统并发症的风险比以往更多。将气管纳入术野可导致术后呼吸系统并发症，即使患者术前无呼吸功能障碍。然而，我们还没有发现任何报告描述标准的术后呼吸功能在这一领域。我们试图获得一个更好的了解目前的状况，在牙科学院和牙科学校医院，并研究最佳的方法，为管理呼吸功能后，口腔颌面外科手术。从而提高我们预测和预防术后呼吸并发症的能力。的牙科学院和牙科学校医院回答说，由牙科麻醉师进行术后患者管理。AMA ...更多信息在接受全身麻醉的患者中，4.3%的患者麻醉时间延长至10小时或更长;几乎所有这些患者都接受了恶性肿瘤手术。然而，很少有机构有术后呼吸管理的指南，不到一半的机构有人工呼吸器。在我们医院，大约4.8%的患者需要延长麻醉时间。根据Okutsu等人建立的预测术后呼吸系统并发症的评分系统进行评估时，约97%的患者术后呼吸系统并发症的风险增加。然而，事实上，没有任何患者发生严重并发症。术后使用人工呼吸器进行呼吸管理，可明显预防此类并发症。因此，接受长时间麻醉的患者需要在术后至少24小时进行丙乳人工呼吸。呼吸功能受损尤其存在于老年患者中，即使他们没有接受长期手术，术后呼吸系统并发症的发生率也很高。术后潮气量低于术前，术后肺活量下降 * 30%被认为是预防性人工通气的指征。少