發(fā)布時間：2018-04-20 11:16

  本文選題：麻醉前準(zhǔn)備 + 體況分析�。� 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：近年來,由于國內(nèi)寵物的飼養(yǎng)量逐年增加,寵物診療行業(yè)發(fā)展迅速,對現(xiàn)代獸醫(yī)臨床麻醉的要求也越來越高。麻醉師既要確保寵物在安全舒適的環(huán)境下順利完成手術(shù)操作,還要在麻醉和手術(shù)中主動監(jiān)測、調(diào)整和控制寵物的生理功能,防止并發(fā)癥的發(fā)生,從而擴(kuò)大了手術(shù)的適應(yīng)癥,降低了進(jìn)行復(fù)雜手術(shù)寵物的死亡率。所以,這就要求了我們獸醫(yī)工作者要對現(xiàn)在獸醫(yī)麻醉技術(shù)進(jìn)一步完善。而本文研究的就是在麻醉技術(shù)中相當(dāng)重要的麻醉前準(zhǔn)備及麻醉前對患病動物體況的評估與糾正。麻醉前準(zhǔn)備包括對麻醉設(shè)備的準(zhǔn)備,患病動物的麻前評估、體況糾正麻醉方案的選擇等。麻醉前準(zhǔn)備的是否完善直接決定著麻醉的成功與否,直接影響動物的生命。通過對動物身體狀況的臨床檢查,來決定麻醉方案和給予用藥。一個完整的麻前準(zhǔn)備方案能減少動物在麻醉過程中出現(xiàn)的一些可以避免的致命因素。不同的動物需要視體況的差異進(jìn)行不同的麻前準(zhǔn)備。只有針對每一個患病動物制定屬于它自己的麻醉前準(zhǔn)備方案才能保證患病動物有更大的希望存活下來。本課題記錄了吉林大學(xué)附屬動物醫(yī)院共187例手術(shù)病例,對這些病例進(jìn)行統(tǒng)一的分析。71例病例需要術(shù)前糾正異常體況,占所有手術(shù)比例中的37.97%。21例生理手術(shù)未做術(shù)前檢查,占11.23%。12例外傷處理未做術(shù)前檢查,占6.42%。34例由于費用原因主人未做術(shù)前化驗,占18.18%。在做完麻前評估與糾正后手術(shù)的病例,死亡率為1.89%。而未做麻醉前評估糾正的病例死亡率為6.17%�？梢娊�(jīng)過系統(tǒng)的麻前準(zhǔn)備及體況評估糾正對降低動物的死亡率有相當(dāng)重大的意義。在需要糾正體況的病例中,其中白細(xì)胞總數(shù)過高、酸堿平衡紊亂、脫水、貧血所占的比例相對較高。偶見肝腎功能異常、心肺功能異常及凝血異常等情況。上述71例病例需要進(jìn)行體況糾正的病例中白細(xì)胞總數(shù)過高的病例有37例,占52.11%。白細(xì)胞總數(shù)過高主要見于機(jī)體炎癥、急性感染、尿毒癥、嚴(yán)重?zé)齻�、急性出血、組織損傷等,通過抗生素的給與,可以適當(dāng)糾正。酸堿平衡紊亂的有34例,占47.89%。最常見的是患病動物體內(nèi)酸性物質(zhì)產(chǎn)生過多或堿性物質(zhì)丟失過多而引起的代謝性酸中毒,占所有酸堿平衡紊亂病例中的61.76%。在臨床中通過堿性藥物的給與,都起到了良好的糾正效果。脫水的病例有16例,占22.54%。臨床上脫水主要見于嘔吐、腹瀉等大量體液丟失引起。通過合理的補(bǔ)充體液,脫水情況會很好的糾正。貧血的病例有19例,占26.76%。引起患病動物貧血的原因有很多,常見的為出血性貧血及溶血性貧血,偶見營養(yǎng)不良性貧血。嚴(yán)重貧血的病例通過輸血糾正后再進(jìn)行麻醉,麻醉風(fēng)險大大降低。綜上所述,本文旨在研究一個針對廣大患病動物的系統(tǒng)的麻醉前準(zhǔn)備方案,為獸醫(yī)工作者及動物主人提供一個可參考的麻醉前指南。降低動物在手術(shù)過程中死亡的風(fēng)險,推進(jìn)寵物麻醉技術(shù)的發(fā)展。
[Abstract]:In recent years, as the raising of pets in China has increased year by year, pet diagnosis and treatment industry has developed rapidly, and the requirements for modern veterinary clinical anesthesia are becoming higher and higher. The anesthesiologist should not only ensure the smooth operation of pets in a safe and comfortable environment, but also monitor the animals in anesthesia and operation, adjust and control the physiological functions of pets and prevent the pets. The occurrence of complications increases the indication of the operation and reduces the mortality of the pet in the complex operation. Therefore, this requires our veterinarian to further improve the current veterinary anesthetic technique. This article is a study of the significant pre intoxication preparation in the anesthesia technology and the evaluation of the condition of the sick animals before anesthesia. Pre anesthesia preparation includes preparation of anesthetic equipment, pre anesthesia assessment of the sick animals, the selection of body condition and the selection of anesthetic schemes. The completion of pre anaesthesia directly determines the success of anesthesia directly affecting the life of animals. By clinical examination of the physical condition of animals, the anesthetic scheme and medication are determined. A complete preparedness plan can reduce some avoidable fatal factors in the process of anaesthesia. Different animals need to make different pre anesthesia preparations for the differences in body conditions. A total of 187 cases of surgical operations in the affiliated Animal Hospital of Jilin University were recorded. A unified analysis of these cases was carried out..71 cases needed to correct abnormal body conditions before operation, which accounted for 37.97%.21 cases in the proportion of all operations without preoperative examination, accounting for the exception of 11.23%.12 exceptions before operation, accounting for 6.42%.34 cases. The cause was not performed before the operation, and the 18.18%. was performed before the pre anesthesia evaluation and correction, the death rate was 1.89%. and the mortality rate corrected before anesthesia was 6.17%.. It was significant to correct the mortality of the animals by systematic pre anesthesia preparation and body condition assessment. Among the cases, the total number of white blood cells, acid-base balance disorder, dehydration, anemia accounted for a relatively high proportion. I see abnormal liver and kidney function, abnormal cardiopulmonary function and coagulation abnormality. In these 71 cases, there are 37 cases of high total white blood cells in the cases that need to be corrected in the case of body condition, accounting for the majority of the total 52.11%. white blood cells. Inflammation, acute infection, uremia, severe burns, acute bleeding, tissue damage, and so on, can be properly corrected through the administration of antibiotics. 34 cases of acid-base balance disorder are the most common in 47.89%., metabolic acidosis caused by excessive acid production or excessive alkaline substance loss in the body of the sick animals, which account for all acid-base levels. The 61.76%. in the disorder cases has been well corrected in clinical use of basic drugs. 16 cases of dehydrated cases, accounting for 22.54%. clinical dehydration, are mainly seen in vomiting, diarrhea and other loss of fluid. The dehydration can be corrected well through reasonable supplement of body fluid. 19 cases of anemia, accounting for 26.76%. There are many causes of anemia in sick animals, such as hemorrhagic anemia and hemolytic anemia, and Diaplastic anemia. The cases of severe anemia are anaesthetized after blood transfusion, and the risk of anaesthesia is greatly reduced. Veterinary surgeons and animal owners provide a reference anaesthetic guideline to reduce the risk of death during surgery and promote the development of pet anesthetic technology.

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：S857.124

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本文編號：1777526