[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$f4ZC2Z2886fdF78OxSCqXJk62DRHCDVYTH0g7AFxkoFg":8,"$fAYMGXc0ODjdNdOPVUdox4rMmCFfPMMoP7S5ztw5DlZA":60,"$fhn9IQ5JWcbznYdixwn-UkwlKQ8xcR1zPfmZxn4lM_Wo":61,"$f2ozFtwFzDDxLvaB01h4TOwHjymnfYFPN0wWUz1QOOWc":81},{"code":4,"msg":5,"message":6,"data":6,"success":7},401,"认证失败，无法访问系统资源",null,false,{"code":9,"msg":10,"message":6,"data":11,"success":59},200,"操作成功",{"id":12,"specialistId":13,"specialistAssistants":14,"profilePhoto":15,"specialistName":16,"roleType":17,"adept":18,"hospital":19,"department":6,"postsTitle":20,"materialTotal":17,"videoTotal":21,"isConcern":7,"title":22,"coverVertical":23,"coverAcross":24,"directionMarker":25,"description":26,"vid":27,"time":28,"mediaType":29,"views":30,"likes":17,"isThumbsUp":7,"isCollection":7,"collections":17,"createTime":31,"seoTitle":32,"seoKeywords":33,"seoDescription":34,"shelvesTime":35,"menus":36,"menuId":38,"type":25,"quality":56,"commentCount":17,"isComment":29,"deviceType":57,"url":58},9652,871489,[],"https://ystcdn.venuertc.com/venue/app/37974/2025-12-16/9a309a65-929f-4740-970f-b53b9b483ab5.png","周洁",0,"各类疾病治疗","苏州市立医院","副主任医师",6,"75岁高龄患者髌骨折手术中的麻醉安全与术后管理实务","https://cdn.yishi-tong.com/console/3/CVEW_1RheHDiRg5z6mbEFPa6gEfKPZms.png","https://cdn.yishi-tong.com/console/3/waSLRSt03HV48quuPQQlXjuaxORuw9QM.png",2,"\u003Cdiv>\u003Cp>我是苏州市立医院重症科的医生我叫周洁，我们经常接诊一些手术患者，在日常工作中经常会和家属聊起“麻醉”二字，大家的想法天差地别。有的担心麻醉后醒不过来，有的觉得术后疼痛没法忍，对高龄、尤其是像75岁的老人做骨折手术，更是五味杂陈。刚好就在不久前，我们科室迎来一位这样的患者，经历过一场“全麻+骨折复位”，这背后到底得注意啥？其实远不止你想的那么简单。\u003C/p>\u003Cp>🔍 很多人只把麻醉看成是“打一针迷药”，但其实麻醉就像电脑的防火墙，帮身体暂时筛除外界的痛感和紧张。对于高龄骨折患者，光是让人睡着还不够，我们还得像守护“主机”一样，时时监控呼吸、心跳，保证血压稳定，防止毒素“入侵”，因为年龄大加上肺部有疾病，哪怕一个小波动，都可能引起麻烦。全身麻醉的选择需结合手术类型、患者身体状况、麻醉药物特性三大核心因素综合判定，\u003C/p>\u003Cp>比如按手术需求选：短时间微创操作（如无痛胃肠镜）可选静脉全麻，起效快、苏醒迅速；长时间复杂手术（如胸腹腔大手术）需静吸复合全麻，通过静脉药+吸入麻药组合，维持麻醉深度稳定，便于术中调控。\u003C/p>\u003Cp>2. 按患者情况选：老年患者、肝肾功能不全者，优先选代谢快、副作用小的短效药物（如丙泊酚、瑞芬太尼），减少脏器负担；肥胖患者需关注药物剂量调整，避免因脂肪蓄积影响苏醒；气道异常（如困难气道）患者，需提前规划插管方案，搭配合适的镇静、肌松药物。\u003C/p>\u003Cp>3. 结合麻醉安全性：需评估患者过敏史，避免使用致敏药物（如某些肌松药）；术中需持续监测生命体征，根据手术刺激强度动态调整麻醉深度，平衡镇痛、镇静、肌松效果。\u003C/p>\u003Cp>⚠️ 说到手术风险，大家最怕的其实是“术后醒不过来”“疼痛难忍”这些事。像这位75岁的患者，除了骨折还带着肋骨损伤和肺炎，手术麻醉难度直线上升。曾经我遇到过类似患者，术后呼吸稍有不顺就住进了重症病房。但别被吓到，现代麻醉手段已经让大多数人安全度过危机，只要术中监护到位，术后镇痛及时，恢复速度能让人吃惊。甚至像这位老人，六天就顺利出院了。关键还是坚持“早期活动”和合理用药，别让小病变大事。\u003C/p>\u003Cp>✅实话说，做好麻醉安全和术后管理并不复杂——第一步，术前主动跟医生聊一聊慢性病史，别怕“麻烦”；第二，术后哪怕没什么大痛，也别偷懒，慢试着下床活动；第三，吃药和康复指导千万按时做，遇到急性气短、剧烈疼痛就要马上反映。医生在术后会持续观察生命体征，调配药物，目的就是防止并发症。不用自己硬扛，及时沟通最重要。说到这里，不管是高龄还是有基础病，只要遵医嘱，手术后康复就没那么难了！\u003C/p>\u003Cp>🌱 其实年纪大也能顺利挺过手术，只要每一步都上点心。早点了解这些安全技巧，你就比“临阵抱佛脚”要省心太多。保护好自己，也给家人少添担忧，聪明面对麻醉和术后管理，就是健康的保障\u003C/p>\u003C/div>","v0d47cg10004d607pvqljhteqkcgni00",223,1,504,"2026-01-22 00:27:10","75岁高龄患者髌骨骨折手术麻醉安全与术后管理要点解析  ","高龄患者麻醉安全,髌骨骨折手术,术后疼痛管理,老年骨科麻醉,围手术期风险控制  ","本文详细探讨75岁以上高龄患者髌骨骨折手术的麻醉选择策略、术中安全注意事项及术后康复管理方案，涵盖风险评估、用药规范、并发症预防等临床实务要点，为骨科与麻醉科医师提供专业参考。","2026-02-04 06:30:00",[37],{"menuId":38,"menuName":39,"parentId":17,"orderNum":40,"path":41,"component":42,"isFrame":43,"isCache":44,"menuType":45,"visible":29,"status":17,"createDept":6,"remark":46,"createTime":47,"children":48,"columnImage":49,"columnLogo":50,"uncheckedLogo":6,"checkedLogo":6,"isHot":17,"isHome":17,"forceLogin":17,"color":6,"seoTitle":51,"seoKeywords":52,"seoDescription":53,"contentNum":6,"promotionalPoster":54,"menuFrame":7,"innerLink":7,"parentView":7,"routeName":55,"routerPath":41,"componentInfo":42},"1986622624134549505","科普视频",3,"video","/video.html","1","0","T","","2025-11-07 10:31:58",[],"https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:09:40/0d7fcb56-3dc4-4dcb-99ca-a5d5c438378e.png","https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:09:43/958efac7-dd02-4681-b8fd-0dd84b1bbf42.png","健康科普视频大全,了解你的健康生活","健康科普视频, 戒烟视频, 饮食健康视频, 胸痛科普, 用药知识, 职业健康视频, 贫血科普, 眼健康视频","精选健康科普视频,涵盖戒烟、胸痛、饮食、用药与职业健康等多个主题,让你轻松获取科学健康知识,提升生活质量。","https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:09:45/fa8fe113-deaa-4454-8105-d629769963dd.png","Video","重大疾病",4,"https://vod.haohuanjiao.com/huanjiao/specialistVideo/871489/c00744ba-f9da-484a-b701-54182e76f4bd.tmp?a=0&auth_key=1789067942-439e633889744fe6b00e7ee1d275d2fd-0-ea2efdec0b882bc64c6f5013af0d0454&br=841&bt=841&cd=0%7C0%7C0&ch=0&cr=0&cs=0&dr=0&ds=4&eid=v0d47cg10004d607pvqljhteqkcgni00&er=0&l=20260811171513AD63443A50F664351DDF&lr=&mime_type=video_mp4&net=0&pl=0&qs=13&rc=M2xqbmhrb3k6OTczNGY3M0ApM3FmdHdtdHMzZzMzajpneWcta2BucWdubS1hLS1kNGFzcy1mZGhiZWlzNDMxLS5gMS06Yw%3D%3D&vl=&vr=",true,{"code":9,"msg":58,"message":6,"data":6,"success":59},{"code":9,"msg":10,"message":6,"data":62,"success":59},{"pageNo":29,"pageSize":63,"result":64,"totalSize":25},10,[65,74],{"id":66,"updateTime":67,"averageScore":68,"posts":20,"specialistId":69,"userName":70,"hospital":71,"avatar":46,"description":72,"department":73},32063,"2026-04-20 15:24:14",9.5,879660,"秦伟","连云港市立东方医院","本视频主要针对75岁老年患者髌骨手术术中镇痛及术后管理作出分析评价，术中镇痛需注意镇痛效果同时，需注意患者有无心肺基础疾病，药物的PK/PD及呼吸、循环有无抑制等问题，术后需注意呼吸抑制及肺部感染加重问题，分析到位，为临床提供很好借鉴经验。","重症",{"id":75,"updateTime":6,"averageScore":76,"posts":20,"specialistId":77,"userName":78,"hospital":19,"avatar":46,"description":79,"department":80},30195,9.7,876847,"刘政操","周洁医生以75岁高龄髌骨骨折患者为切入点，系统拆解了老年患者麻醉与术后管理的核心要点。视频打破了“麻醉就是打一针迷药”的认知误区，用“电脑防火墙”的比喻清晰阐释了高龄患者的麻醉管理逻辑；同时围绕麻醉方案选择、术中个体化用药、术后并发症防控三大维度，给出了适配老年患者的精细化管理策略，兼具临床专业性与大众可读性，为高龄手术患者提供了科学的认知参考。","肿瘤科",{"code":9,"msg":10,"message":6,"data":82,"success":59},{"authors":83,"appraiseDimensionScoresVos":88},[84,86],{"profilePhoto":46,"specialistId":85},"876847",{"profilePhoto":46,"specialistId":87},"879660",[89,95,100,105,109],{"id":90,"scores":91,"value":92,"dimensionId":6,"avgs":93,"title":94},279614,30,28,9.08333,"内容准确性",{"id":96,"scores":97,"value":97,"dimensionId":6,"avgs":98,"title":99},279615,20,9.25,"内容深度与广度",{"id":101,"scores":97,"value":102,"dimensionId":6,"avgs":103,"title":104},279616,18,9.75,"语言表达",{"id":106,"scores":107,"value":107,"dimensionId":6,"avgs":63,"title":108},279617,15,"呈现形式",{"id":110,"scores":107,"value":107,"dimensionId":6,"avgs":68,"title":111},279618,"教育价值"]