非气管插管胸腔镜下肺癌手术的临床应用

发布时间：2018-04-15 00:24

本文选题：喉罩 + 气管内插管　；参考：《中国内镜杂志》2017年08期

【摘要】：目的评估非气管插管麻醉下胸腔镜肺癌手术的可行性和安全性。方法实验组与对照组各20例周围型肺癌患者。实验组采用喉罩通气麻醉、对照组采用气管插管麻醉行胸腔镜下肺部手术,监测并记录各组诱导前(T0)、诱导插管时(T1)、手术实施时(T2)和苏醒拔管时(T3)患者的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)、心电图(ECG)、脉搏血氧饱和度(Sp O2)、呼末二氧化碳分压(PETCO2)、中心静脉压、有创动脉血压及血糖指标,并记录患者术后的相关并发症,如有无咽痛、声音嘶哑和恶心等。结果喉罩组患者麻醉过程中对心血管系统刺激小,术后进食、排气、下床活动时间、平均住院日缩短,住院费用降低,咽部、呼吸及心血管系统并发症少于插管组。结论喉罩通气静脉麻醉配合胸内迷走神经阻滞在胸腔镜肺叶切除术中操作简易、安全性好、无插管相关并发症及单肺通气肺部损伤,符合手术-麻醉整体微创发展的理念,值得临床推广。
[Abstract]:Objective to evaluate the feasibility and safety of thoracoscopic lung cancer surgery under non-tracheal intubation anesthesia.Methods 20 patients with peripheral lung cancer were treated in the experimental group and 20 in the control group.The experimental group was anesthetized with laryngeal mask ventilation, the control group was treated with tracheal intubation anesthesia, and the control group underwent thoracoscopic lung surgery.Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAPP), heart rate (HRP), electrocardiogram (ECG), pulse oxygen saturation (spp), end-respiratory carbon dioxide (CO _ 2) were monitored and recorded in each group.Pressure of PETCO _ 2, central venous pressure,Invasive arterial blood pressure and blood glucose were recorded, and postoperative complications such as sore throat, hoarseness and nausea were recorded.Results the laryngeal mask group had less stimulation to cardiovascular system after operation, feeding, exhausting, moving out of bed, shorter average hospitalization time, lower hospitalization cost, less complications of pharynx, respiration and cardiovascular system than intubation group.Conclusion laryngeal mask ventilation intravenous anesthesia combined with intrathoracic vagus block is simple and safe in thoracoscopic lobectomy. There are no complications associated with intubation and lung injury in single lung ventilation, which is in line with the concept of minimally invasive surgery and anesthesia.It is worth popularizing in clinic.
【作者单位】：中国石油天然气集团公司中心医院胸外科;廊坊卫生职业学院内科教研室;
【基金】：河北省省级科技计划-社会科技事业及医疗卫生技术专项(No:16277737D)
【分类号】：R614;R734.2

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