【原】Case Files: Anesthesiology 学习笔记(112)颅内占位开颅切除术5.

麻花慧慧子 2022-06-28 发布于浙江

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Case 28 Craniotomy for Brain Mass Excision

Any acute deterioration in mental status or a new deficit suggests worsening cerebral edema or an intracranial bleed and requires an immediate intervention such as a CT scan or MRI.

1. ventriculostomy [venˌtrɪkjʊ'lɒstəmɪ] n.【医】脑室开孔术 A ventriculostomy, also called an external ventricular drain (EVD, 脑室外引流)or ventricular catheter, is a catheter placed into the ventricles, fluid-filled spaces within the brain, and drains cerebrospinal fluid (CSF, 脑脊液) externally. → ventricle ['ventrɪk(ə)l] n.心室；（体内的）室；（尤指）脑室

2. lumbar drain 腰椎引流 What is a Lumbar drain? A small, flexible, soft plastic tube placed in the lower back (lumbar area) in the arachnoid ([ə'ræknɔɪd] adj.【解】蛛网膜的) space to drain cerebrospinal fluid (CSF). Used to drain some of the cerebrospinal fluid that fills the ventricles of the brain and surrounds the brain and spinal cord.

3. supratentorial [ˌsuːprəten'tɔ:riəl] 幕上的 → tentorium [ten'tɔ:riəm] n.幕骨Supratentorial craniotomy means the exposure of any part of a cerebral hemisphere over the basal line joining the nasion (['neɪzɪɒn] n.鼻根点) to the inion (['ɪnɪən] n.【解】枕骨隆突). pref.表示“在下”；“在下部”; supra- pref.上

cerebrum [səˈriːbrəm] n.大脑

cerebellum [.serə'beləm] n.小脑

4. premedication [ˌpri:ˌmedɪ'keɪʃn] n.麻醉前用药；drugs given to sb in preparation for an operation or other medical treatment

5. hypotonic [ˌhaɪpə'tɒnɪk] adj.【医】张力减退的；【化】低渗性的

6. ringer lactate [ˈrɪŋə(r)] [lækˈteɪt] 林格氏液

Ringer's lactate solution, or lactated Ringer's solution, is a type of isotonic, crystalloid fluid further classified as a balanced or buffered solution used for fluid replacement. The contents of Ringer's lactate include sodium, chloride ([ˈklɔːraɪd] n.氯化物), potassium ([pə'tæsiəm] n.钾), calcium, and lactate in the form of sodium lactate, mixed into a solution with an osmolarity ([ɒzmə'lærɪtɪ] n.渗透压) of 273 mOsm/L and pH of about 6.5.

* Osmolarity is the total solute concentration within a specific volume of a solvent expressed in osmoles per liter (Osm/L) or milliosmoles per liter (mOsm/L). osmolarity是物理学术语，为表示某溶液的渗透压，有时使用与该溶液具有等渗的非电解质溶液的克分子浓度，称此为克分子渗透压浓度，以渗透克分子（osmole，Osm），或毫渗透克分子（m osmole， m Osm）来表示。

(large right sided secondary pneumothorax)

7. dextrose [ˈdekˌstrəʊz] n.右旋糖 Dextrose (corn sugar) is a simple sugar that is made from cornstarch and is chemically similar to glucose, or blood sugar. Dextrose is also known as D-glucose. Glucose is a source of energy, and all the cells and organs in your body need glucose to function properly.

8. pneumothorax [njuːməʊˈθɔːræks] 气胸 “Pneumothorax” is the medical term for a collapsed lung. Pneumothorax occurs when air enters the space around your lungs (the pleural space). Air can find its way into the pleural space when there’s an open injury in your chest wall or a tear or rupture in your lung tissue, disrupting the pressure that keeps your lungs inflated. pneumo- na.表示“肺”

9. impede [ɪmˈpiːd] [oftpass] v.阻碍；阻止 ~ sth to delay or stop the progress of sth

10. Trendelenburg position [ˈtrendələnbərg] 特伦德伦伯卧位，仰卧头低位

The Trendelenburg position is a position for a patient on the operating table, most commonly used during lower abdominal surgeries and central venous catheter placement. In Trendelenburg position, the patient is supine ([ˈsuːpaɪn] adj.仰卧的) on the table with their head declined below their feet at an angle of roughly 16°. The degree of Trendelenburg should be minimized as much as possible, and if possible, the patient should be repositioned into the supine or reverse Trendelenburg position at established intervals.

Positioning a patient for a surgical procedure involves reducing risk of injury and increasing comfort. The Trendelenburg position allows a surgeon greater access to pelvic organs, helpful for procedures like colorectal ([kəʊlə'rektəl] 结肠直肠的), gynecological ([ˌɡaɪnɪkəˈlɒdʒɪkl] adj.妇科学的), and genitourinary ([ˌdʒenɪtəʊ'jʊərɪnərɪ] adj.泌尿生殖器的) surgery. As with all surgical positions, risks must be assessed prior to positioning a patient in Trendelenburg position. For example, risks to a patient while in Trendelenburg include diminished lung capacity, tidal volume and pulmonary compliance, venous pooling toward the patient’s head. Trendelenburg position should be avoided for extremely obese patients.

* Venous pooling is also known as chronic venous insufficiency or venous reflux occurs when the small valves in our leg veins become damaged and no longer function properly.