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麻醉实现从胎儿到百岁老人

2017-08-20 08:22:26   中国青年网

根据世界卫生组织的报告,每年有2.34亿人接受手术麻醉,相当于每年每25人中就有一人要接受手术麻醉。

现代麻醉学科的发展已经可以做到“麻醉无绝对禁忌症”,既往“不能做”的手术、“不能麻”的病人现在都能做,而国家政策的支持、医疗的投入、医护人员的长期努力、麻醉理念和技术的进步为此提供了保障。

麻醉学已经能够对患者生命体征和内环境情况全面掌控。越来越多的医疗机构将术中体温监测、体温保护作为常规。自体血回输全国普及率已达到23.9%。大部分医疗机构已开展各类术中实时监测:经食道超声术中实时评估患者心功能;血栓弹力图测定实时测定患者凝血功能;高级有创血流动力学监测实时评估患者血流动力学指标。

麻醉从子宫内胎儿、新生儿到百岁老人,解决了“不敢”、“不能”手术的问题。已开展微创、个体化的术中管理。比如在北京协和医院80岁以上的高龄患者髋部骨折手术,通过个体化的方案,麻醉成功率为100%,97.29%的患者痊愈出院。

麻醉科是现代手术发展的前提。过去的25年,2大外科技术:移植技术、微创技术(包括介入、腔镜、达芬奇机器人手术)的发展,就是建立在现代麻醉之上。

我国麻醉相关死亡率低于发展中国家平均水平。与上世纪90年代初我国约万分之一左右的麻醉相关死亡率比较,目前有了显著改善,已低于发展中国家的平均水平。在某些大型三甲医院(华西)已达到20万分之一。

为确保患者安全,国家卫生和计划生育委员会麻醉专业质量控制中心(国家麻醉质控中心)于2011年正式成立,截至2016年底,除西藏自治区外,全国各省、自治区、直辖市相继成立了临床麻醉质控中心。截至目前,麻醉记录单的国家标准已于2011年颁布,并在2016年联合国家卫生监督中心进行了追踪评价;历数年修改,《麻醉专业医疗质量控制指标》已于2015年正式公布。

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