摘要： 目的   探讨神经外科全身麻醉手术患者在麻醉后恢复室并发症的发生情况并分析可能的原因，以期增加神经外科手术患者围麻醉期安全。方法   回顾2009 年3 月-2010 年1 月神经外科手术后患者在麻醉后恢复室中的临床监测资料，分析并发症发生原因，总结防治特点。结果   2414 例神经外科手术后患者在麻醉后恢复室的平均观察时间为2 h，并发症发生率为52.57%（1269/2414），其中486 例兼有两种以上并发症，发生率约为20.13%。常见并发症包括心律失常（340 例，14.08%）、高血压（333 例，13.79％）、疼痛（330 例，13.67%）、寒战（246 例，10.19%）、恶心呕吐（222 例，9.20%）、谵妄躁动（215 例，8.91%），较少发生低氧血症（79 例，3.27%）、呼吸道梗阻（48 例，1.99%）、苏醒延迟（34 例，1.41%）、低血压（12 例，0.50%）等并发症。3 例患者由于脑水肿或脑内血肿再次手术。结论   神经外科手术后并发症发生率较高且情况复杂，不同疾病种类和手术方式可能出现与之相关的特殊并发症；麻醉后恢复室医师宜在患者恢复期针对不同神经外科手术种类，严密监测并发症，并及时处理，确保患者安全。

关键词: 麻醉, 全身, 麻醉恢复期, 苏醒室, 手术后并发症, 神经外科手术

Abstract: Objective To explore the complications neurosurgical patients with general anesthesia in neurosurgical postanesthesia care unit (PACU), and analyse the probable cause to enhance the safety of neurosurgical patients in perioperative period. Methods The clinical monitor data (March, 2009-January, 2010) of 2414 patients in neurosurgical PACU after neurosurgical operation were reviewed. The causes of complication were analysed and characteristics of prevention and treatment were summarized. Results The mean monitor duration in PACU was 2 hours. The incidence of complication was 52.57% (1269/2414). There were 486 patients (20.13% ) suffered from 2 or more than 2 complications. The incidence of arrhythmia, hypertension, pain, shivering, nausea and vomiting, and delirium was 14.08%, 13.79%, 13.67%, 10.19% , 9.20% and 8.91% , respectively. The incidence of hypoxemia, respiratory obstruction, delayed recovery and hypotension was 3.27% , 1.99% , 1.41% and 0.50% , respectively. Three patients with consciousness delay or pupil size anisocoria diagnosed as cerebral edema or intracranial hematoma by computed tomography (CT) underwent recraniotomy. All complications were treated in time. Conclusion The incidence of neurosurgical postoperative complications is fairly high. Different kinds of disease and operation may present special related complications. All complications should be monitored and treated promptly and accurately to secure the safety of patients in PACU.

Key words: Anesthesia, general, Anesthesia recovery period, Recovery room, Postoperative complications, Neurosurgical procedures