胸腔镜交感神经切断术不同气管插管麻醉的前瞻性研究

发布时间：2018-06-12 10:07

本文选题：胸腔镜 + 气管插管　；参考：《中国内镜杂志》2015年06期

【摘要】：目的比较单腔或双腔气管插管麻醉在手汗症患者行针形胸腔镜(VATS)双侧T3、4交感神经链切断术中的安全性、可行性及成本效益优势。方法前瞻性研究2013年7月-2013年12月于该科行针形VATS双侧T3、4交感神经链切断术的40例手汗症患者,随机分成两组,每组20例,分别采用单腔气管插管麻醉或双腔气管麻醉。比较两组的插管时间、手术时间、住院天数、麻醉费用及住院费用,术后30 d随访两组的手汗缓解及代偿性多汗情况。结果两组困难插管率、手术时间、住院时间、并发症发生率、手汗缓解率及代偿性多汗发生率差异均无显著性(P0.05)。单腔气管插管组插管时间[(6.85±1.50)vs(14.70±3.31)min,t=9.664,P=0.000)]、麻醉费用[(3 028.65±252.60)vs(4 055.25±259.60)元,t=12.675,P=0.000)]及手术费用[(8 380.75±339.70)元vs(9 468.85±420.39)元,t=9.003,P=0.000]均明显低于双腔气管插管组,差异有显著性(P0.05)。结论单腔或双腔气管插管麻醉对于针形VATS双侧T3、4交感神经链切断术均安全、可行。单腔插管与双腔插管相比,能有效缩短插管时间,具有较好的成本效益优势。
[Abstract]:Objective to compare the safety, feasibility and cost benefit of single or double lumen tracheal intubation anesthesia in patients with hand hyperhidrosis. Methods from July 2013 to December 2013, 40 patients with palmar hyperhidrosis treated with needle vats bilateral sympathetic chain transection were randomly divided into two groups, each group (n = 20), which were treated with single-chamber tracheal intubation anesthesia or double-lumen tracheal anesthesia respectively. The intubation time, operation time, hospital stay, anaesthesia cost and hospitalization cost were compared between the two groups, and hand sweat relief and compensatory hyperhidrosis were followed up 30 days after operation. Results there was no significant difference in the rates of difficult intubation, operation time, hospital stay, complication rate, hand sweat remission rate and compensatory hyperhidrosis rate between the two groups (P 0.05). The intubation time [6.85 卤3.31 1.50)vs(14.70 卤3.31 min], anesthesia cost (3 028.65 卤252.60)vs(4 055.25 卤259.60) and operation cost [8 380.75 卤339.70 yuan vs(9 468.85 卤420.39] were significantly lower than those in the double lumen tracheal intubation group. Conclusion Anesthesia with single or double lumen tracheal intubation is safe and feasible for needle vats bilateral T 3N 4 sympathectomy. Compared with double-chamber intubation, single-chamber intubation can effectively shorten intubation time and has better cost-benefit advantage.
【作者单位】：中山大学附属第三医院心胸外科;中山大学附属第三医院麻醉科;
【基金】：中山大学“985”工程项目(82000-31101301)
【分类号】：R655

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