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讨论：关于反流误吸的思考

2022-02-21 苏毅 深圳大学总医院麻醉科

麻醉反流误吸
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  1. [GetPortalCommentsPageByObjectIdResponse(id=2043230, encodeId=0ca8204323042, content=<a href='/topic/show?id=d0593e768a4' target=_blank style='color:#2F92EE;'>#反流误吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37768, encryptionId=d0593e768a4, topicName=反流误吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Tue May 24 00:43:16 CST 2022, time=2022-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220301, encodeId=c9241220301a2, content=学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d322552799, createdName=ms3000000740036377, createdTime=Tue May 17 15:14:34 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571715, encodeId=e6ac15e1715c0, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Wed Feb 23 02:43:16 CST 2022, time=2022-02-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196208, encodeId=ff3b119620804, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00b23462159, createdName=130a765fm69暂无昵称, createdTime=Tue Feb 22 20:13:11 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196150, encodeId=fe401196150b9, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ede65630636, createdName=ms2000001545439177, createdTime=Tue Feb 22 16:44:00 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1195717, encodeId=e4f01195e174b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac976513572, createdName=ms9000000245242422, createdTime=Mon Feb 21 15:42:03 CST 2022, time=2022-02-21, status=1, ipAttribution=)]
    2022-05-24 vera_1203

    #反流误吸#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2043230, encodeId=0ca8204323042, content=<a href='/topic/show?id=d0593e768a4' target=_blank style='color:#2F92EE;'>#反流误吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37768, encryptionId=d0593e768a4, topicName=反流误吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Tue May 24 00:43:16 CST 2022, time=2022-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220301, encodeId=c9241220301a2, content=学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d322552799, createdName=ms3000000740036377, createdTime=Tue May 17 15:14:34 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571715, encodeId=e6ac15e1715c0, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Wed Feb 23 02:43:16 CST 2022, time=2022-02-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196208, encodeId=ff3b119620804, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00b23462159, createdName=130a765fm69暂无昵称, createdTime=Tue Feb 22 20:13:11 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196150, encodeId=fe401196150b9, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ede65630636, createdName=ms2000001545439177, createdTime=Tue Feb 22 16:44:00 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1195717, encodeId=e4f01195e174b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac976513572, createdName=ms9000000245242422, createdTime=Mon Feb 21 15:42:03 CST 2022, time=2022-02-21, status=1, ipAttribution=)]
    2022-05-17 ms3000000740036377

    学习！

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2043230, encodeId=0ca8204323042, content=<a href='/topic/show?id=d0593e768a4' target=_blank style='color:#2F92EE;'>#反流误吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37768, encryptionId=d0593e768a4, topicName=反流误吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Tue May 24 00:43:16 CST 2022, time=2022-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220301, encodeId=c9241220301a2, content=学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d322552799, createdName=ms3000000740036377, createdTime=Tue May 17 15:14:34 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571715, encodeId=e6ac15e1715c0, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Wed Feb 23 02:43:16 CST 2022, time=2022-02-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196208, encodeId=ff3b119620804, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00b23462159, createdName=130a765fm69暂无昵称, createdTime=Tue Feb 22 20:13:11 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196150, encodeId=fe401196150b9, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ede65630636, createdName=ms2000001545439177, createdTime=Tue Feb 22 16:44:00 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1195717, encodeId=e4f01195e174b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac976513572, createdName=ms9000000245242422, createdTime=Mon Feb 21 15:42:03 CST 2022, time=2022-02-21, status=1, ipAttribution=)]
    2022-02-23 feifers

    #反流#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2043230, encodeId=0ca8204323042, content=<a href='/topic/show?id=d0593e768a4' target=_blank style='color:#2F92EE;'>#反流误吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37768, encryptionId=d0593e768a4, topicName=反流误吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Tue May 24 00:43:16 CST 2022, time=2022-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220301, encodeId=c9241220301a2, content=学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d322552799, createdName=ms3000000740036377, createdTime=Tue May 17 15:14:34 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571715, encodeId=e6ac15e1715c0, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Wed Feb 23 02:43:16 CST 2022, time=2022-02-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196208, encodeId=ff3b119620804, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00b23462159, createdName=130a765fm69暂无昵称, createdTime=Tue Feb 22 20:13:11 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196150, encodeId=fe401196150b9, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ede65630636, createdName=ms2000001545439177, createdTime=Tue Feb 22 16:44:00 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1195717, encodeId=e4f01195e174b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac976513572, createdName=ms9000000245242422, createdTime=Mon Feb 21 15:42:03 CST 2022, time=2022-02-21, status=1, ipAttribution=)]
    2022-02-22 130a765fm69暂无昵称

    学习

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2043230, encodeId=0ca8204323042, content=<a href='/topic/show?id=d0593e768a4' target=_blank style='color:#2F92EE;'>#反流误吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37768, encryptionId=d0593e768a4, topicName=反流误吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Tue May 24 00:43:16 CST 2022, time=2022-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220301, encodeId=c9241220301a2, content=学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d322552799, createdName=ms3000000740036377, createdTime=Tue May 17 15:14:34 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571715, encodeId=e6ac15e1715c0, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Wed Feb 23 02:43:16 CST 2022, time=2022-02-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196208, encodeId=ff3b119620804, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00b23462159, createdName=130a765fm69暂无昵称, createdTime=Tue Feb 22 20:13:11 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196150, encodeId=fe401196150b9, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ede65630636, createdName=ms2000001545439177, createdTime=Tue Feb 22 16:44:00 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1195717, encodeId=e4f01195e174b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac976513572, createdName=ms9000000245242422, createdTime=Mon Feb 21 15:42:03 CST 2022, time=2022-02-21, status=1, ipAttribution=)]
    2022-02-22 ms2000001545439177

    受益匪浅

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2043230, encodeId=0ca8204323042, content=<a href='/topic/show?id=d0593e768a4' target=_blank style='color:#2F92EE;'>#反流误吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37768, encryptionId=d0593e768a4, topicName=反流误吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=644e456, createdName=vera_1203, createdTime=Tue May 24 00:43:16 CST 2022, time=2022-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1220301, encodeId=c9241220301a2, content=学习！, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d322552799, createdName=ms3000000740036377, createdTime=Tue May 17 15:14:34 CST 2022, time=2022-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1571715, encodeId=e6ac15e1715c0, content=<a href='/topic/show?id=41e33e76137' target=_blank style='color:#2F92EE;'>#反流#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37761, encryptionId=41e33e76137, topicName=反流)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=220d15750403, createdName=feifers, createdTime=Wed Feb 23 02:43:16 CST 2022, time=2022-02-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196208, encodeId=ff3b119620804, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=00b23462159, createdName=130a765fm69暂无昵称, createdTime=Tue Feb 22 20:13:11 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1196150, encodeId=fe401196150b9, content=受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ede65630636, createdName=ms2000001545439177, createdTime=Tue Feb 22 16:44:00 CST 2022, time=2022-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1195717, encodeId=e4f01195e174b, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ac976513572, createdName=ms9000000245242422, createdTime=Mon Feb 21 15:42:03 CST 2022, time=2022-02-21, status=1, ipAttribution=)]
    2022-02-21 ms9000000245242422

    不错

    0

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腰硬联合麻醉后，患者脑脊液持续漏出，怎么办？

一文看懂！

不使用阿片类药物的麻醉，你觉得靠谱吗？

无阿片的多模式麻醉，包括右美托咪定和艾司氯胺酮对接受妇科腹腔镜检查的患者，是可行的，且易于管理。然而，在手术第一天后的恶心呕吐、疼痛评分和吗啡用量方面，它没有显示出明显的优势。

麻醉医生亲自体验“正常”胃镜检查后，需要我们认真思考一个问题：到底要不要坚持无痛胃镜？

由于门诊胃镜检查的病人可能存在检查不全面、准备不充分的情况，大大增加了实施麻醉的风险，因此麻醉医师认为病人不宜接受麻醉的时候可以选择“正常”胃镜。

麻醉科常见医疗事故雷区有哪些？这篇文章说全了！

所谓麻醉医疗事故，是指从事麻醉工作的医护人员在工作过程中，违反医疗卫生管理法律、行政法规、部门规章和麻醉工作制度或技术操作规范、常规，过失造成患者人身损害的事故。

硬脊膜打穿后该如何处理？

药袋内药液用尽后再次配注生理盐水150 ml，设定模式不变。硬膜外持续填充4d，患者无症状或症状轻微者可拔除硬膜外导管，症状严重者可延长至7d拔管。期间需每日清洁消毒穿刺处并更换敷料。

糟了，遇到一例连指南都指导不了的困难气道！

在每一个麻醉医生的职业生涯中，都会遇到一例终身难忘的困难气道。如果处理的好，就是一个可以拿来教学的经典案例，如果处理的不好，就是一个追随一生的阴影和梦魇。

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