这是我写的一点东西，因为课程刚开始，而且当初学的东西都忘得差不多了（当初学的那点麻醉，一直没用过，且距今，已经有十多年了），只是凭记忆能写些。
蓝色部分为我写的。
======================== Lung situations
ABGs (the day before surgery): pH -7.48, PCO2 -33, PaO2 -95, HCO3 -24, HbO2 -96%. --On an FiO2 of 0.28
It’s almost normal and acceptable for the anesthesia.
PFTs: FEF 25-75 --83% of predicted, VC --95% of predicted, FEV1 –85 %.
It’s almost normal and acceptable for the anesthesia.
Hear situation
Twelve Lead ECG: Moderate hypertrophy, R shifted axis, inverted T waves on lead II, Rate -54/m, occasional runs (1 every 5 minutes) of 3-4 uni-focal PVCs
Echo-cardiogram: Large 6 cm intimal aneurism in lower aorta, above renal branching
Heart Sounds: Normal S1 & S2, Mild S 4
Swan-Ganz Data: CVP 5 mmHg, PAP 20/9 mmHg, PCWP 6mmHg, CO 4.1 L/m
BP: 148/96 mmHg; R>L brachial
Summary of the Heart Situation
1. Heart Rate is a little low, but it’s acceptable. Prepare anticholinergic agents, such as Atropine, for the case the heart rate drop off so much during the procedure.
2. BP: 148/96 is a little high. It’s better to decrease it to the normal range.
3. Prepare transfusion for the case of rupture of the AAA during surgery.
4. Prepare vessel dilation agents for the case of increasing BP dreamily when block the blood of the AAA.
5. Closely monitor cardiac situation during the surgery is very important.
电解质
Na+ 139; Normal
K+ 4.9; Normal
Cl- 101 Normal
Ca++ 9.1; Normal
Mg++ 2.7; HIGH (Normal 1.8-2.4), but it’s acceptable HCO3 - 26; Normal
HPO4- 2.6 Normal
BUN 21.5 mg/dL; HIGH. The surgery maybe affect the blood flow to the kidney. Connect with nephrologist for help. Albumin 4.3 g/dL; Normal
Glucose 120 mg/dL; Normal
CBC: Hgb 14.7 gm%, HCT 42%; Platelets 210,000/mm3, WBC – 4,700 /mm3, 4 % bands.
It’s normal作者: 曹医生 时间: 2011-2-17 14:32
一周了，没有回应，太伤心了！作者: 冷冰雁 时间: 2011-2-17 20:17
可能是大家都比较谦虚吧！我是在基层医院，像你说的这种情况我们一般也不去拢他了，况且心功能不是太好。不好意思了，没帮上你。作者: 1001 时间: 2011-2-17 22:22 本帖最后由 1001 于 2011-4-3 00:51 编辑
