拟行无痛胃镜检查期间意外严重呕吐误吸的原因分析及对策

摘要

Objective: To discuss the reason and countermeasure of vomiting and aspiration during anesthesia prepare for gastroscopy.Methods:To retrospectively analyze the clinical data of vomiting and aspiration during anesthesia prepare for gastroscopy since June,2007.aspiration during anesthesia prepare for gastroscopy is relation with the potential disease of the patients and the neglect of doctor.Conclusion: We should screening the patients at first,and then rational use of drug is necessary to enhance the safty of the gastroscopy under anesthesia.Better Prognosis can be got if countermeasure adopted promptly and correctly.%目的:探讨拟行无痛胃镜检查期间并发意外严重呕吐误吸的原因及对策.方法:对2007 年6月以来拟行无痛胃镜检查患者诱导期间意外并发严重呕吐误吸临床资料进行回顾性研究.结果:4200 例无痛胃镜诊疗中,意外发生严重呕吐误吸4例,发生率为1.05%.其共同的临床特点为:术前均较长时间不能进食,检查前常规禁饮;4 例患者严重呕吐误吸均发生于静脉麻醉诱导期间;均引起左侧为主的吸入性肺炎,明显缺氧紫绀;4 例中有3例其后确诊胃幽门部不全梗阻.消化内科和麻醉医师均忽视患者胃内大量积存液以及未作相应准备是主要原因.1例患者经积极抢救,因继发脑梗死死亡.结论:消化内科和麻醉医师均应警惕患者拟行无痛胃镜检查时存在并发严重呕吐误吸的风险,对于可能存在呕吐误吸患者,应尽可能清醒下行胃镜检查.