[1]杨明明,谢凡,袁重阳,等.唤醒麻醉在小儿癫痫脑功能区病灶切除术中的应用研究[J].临床小儿外科杂志,2021,20(10):946-950.[doi:10.12260/lcxewkzz.2021.10.010]
　Yang Mingming,Xie Fan,Yuan Chongyang,et al.Application of awake anesthesia in brain functional area lesion resection for Epileptic Children[J].Journal of Clinical Pediatric Surgery,2021,20(10):946-950.[doi:10.12260/lcxewkzz.2021.10.010]
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唤醒麻醉在小儿癫痫脑功能区病灶切除术中的应用研究

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第20卷 期数: 2021年10期 页码: 946-950 栏目: 论著 出版日期: 2021-10-14
Title:
Application of awake anesthesia in brain functional area lesion resection for Epileptic Children
作者:
杨明明1;  谢凡1;  袁重阳1;  王在臣1;  梁荣耀1;  徐海燕2;  谭红平3;  魏涧琦1
1. 广东三九脑科医院麻醉科(广东省, 510510);
2. 广东三九脑科医院心理科(广东省, 510510);
3. 广东三九脑科医院癫痫中心(广东省, 510510)
Author(s):
Yang Mingming1;  Xie Fan1;  Yuan Chongyang1;  Wang Zaichen1;  Liang Rongyao1;  Xu Haiyan2;  Tan Hongping3;  Wei Jianqi1
1. Department of Anesthesiology, Guangdong 999 Brain Hospital, Guangzhou 510510, China;
2. Department of Psychology, Guangdong 999 Brain Hospital, Guangzhou 510510, China;
3. Epilepsy Center, Guangdong 999 Brain Hospital, Guangzhou 510510, China
关键词:
癫痫; 外科手术; 脑功能区; 唤醒麻醉; 儿童
Keywords:
Epilepsy; Surgical Procedures;  Operative; Brain Function Area; Awake anesthesia; Child
分类号:
R742.1;R614.2
DOI:
10.12260/lcxewkzz.2021.10.010
摘要:
目的 评价唤醒麻醉在小儿癫痫脑功能区病灶切除术中应用的安全性和可行性。方法 整理分析18例在唤醒麻醉下完成小儿癫痫脑功能区病灶切除术患者的一般资料、唤醒麻醉方法、手术体位、术中并发症及术后随访情况。结果 18例患者中，17例采用3A（入睡-清醒-再入睡）模式顺利完成唤醒下癫痫病灶切除术；1例在唤醒后神经功能测试时反复癫痫发作，无法配合，改全身麻醉下完成手术。5例采用仰卧位，13例采用侧卧位。术中并发症：恶心3例，癫痫发作6例，发作预感3例，均经对症处理后好转。18例随访2~7年，未见重要神经功能损伤。Engel分级：Ⅰ级12例，Ⅱ级4例，Ⅲ级2例。结论 小儿癫痫脑功能区病灶切除术采用唤醒麻醉安全可行，关键在于充分的术前准备和精细的麻醉管理。
Abstract:
Objective To evaluate the safety and feasibility of awake anesthesia during brain functional area lesion resection for epileptic children.Methods Clinical data, mode of awake anesthesia, surgical position, intraoperative complications and postoperative follow-ups were recorded for 18 epileptic children undergoing brain functional area lesion resection under awake anesthesia.Results For 17 cases, asleep-awake-asleep (3A) model was adopted and awake lesion resection successful.One case of recurrent seizure during neurological function test after waking was operated under general anesthesia.Body position was spinal (n=5) and lateral decubitus (n=13).Intraoperative complications:included nausea (n=3), seizure (n=6) and premonition (n=3).All symptoms improved after treatments.During a follow-up period of 2-7 years, there has no neurological dysfunction.Engel grade was Ⅰ (n=12), Ⅱ (n=4) and Ⅲ (n=2).Conclusion Awake anesthesia in brain functional area lesion resection is both safe and feasible for epileptic children.The keys are sufficient preoperative preparations and meticulous anesthesia managements.

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备注/Memo

收稿日期:2020-02-20。
基金项目:广东省医学科学技术研究基金项目（编号：B2018169）
通讯作者:魏涧琦,Email:weijianqi@aliyun.com

更新日期/Last Update: 1900-01-01