摘要
目的观察单腔气管导管插管和呼吸暂停在胸腔镜下胸交感神经干切断术中应用的安全性和经济性。方法40例手汗症患者在电视胸腔镜下行双侧T2～T4交感神经干切断术。根据气管插管麻醉的不同分为单腔气管插管组(A组)和双腔气管插管组(B组),每组20例。分别于右侧胸切皮前(T1)、右侧膨肺前(T2)、右侧膨肺后正常机械通气时(T3)、左侧膨肺前(T4)、左侧膨肺后正常机械通气时(T5)、麻醉结束时(T6)记录患者NBP、HR、SpO2、PETCO2及手术侧肺萎陷情况、暂停通气(或单肺通气)时间、相关并发症和麻醉费用情况。结果围术期两组患者SBP、DBP、HR均在正常范围内,两组SpO2均能维持在98%以上。T3、T5时A组PETCO2较T1时明显升高(P<0.01),并显著高于B组(P<0.01)。A组手术侧肺萎陷理想,手术野暴露满意,平均暂停通气时间为7.3min,最长为16min。B组患者双腔气管导管插管均成功,有7例肺萎陷不理想。术后第1天A组声音嘶哑、咽喉痛的发生率较B组略低。A组麻醉费用显著低于B组(P<0.01)。结论单腔气管导管麻醉和呼吸暂停在胸腔镜下胸交感神经干切断术中应用具有插管快速、安全、并发症少和花费少的优势。
Objective To evaluate the safety and expense of single-lumen tracheal tube anesthesia and apneic ventilation used in thoracoscopic sympathectomy. Methods Fouty patients with hyperhidrosis under general anesthesia for thoracoscopic sympathectomy were retrospectively divided into two groups with 20 cases each. Group A was intubated with single-lumen tracheal tube and apneic ventilation during operation. Group B was given double-lumen endotracheal tube and one-lung ventilation during operation. BP, HR, SpO2, PETCO2 were monitored and lung collapsing condition of the surgery side, apneic ventilation time （or one-lung ventilation time ）, intubation relative complications and anesthesia expense were also recorded. Results The BP, HR,SpO2 were in normal range in two groups. PETCO2 in group A was significantly higher than that before operation and in group B at the times of before inflating the right side lung and after mechanical ventilation （P〈 0.01）. The lung on the surgery side was collapsed and exposed satisfactorily in group A. Average time of apneic ventilation was 7. 3 min.In group B, pulmonary collapse of 7 cases was unsatisfied. Postoperative hoarseness and sore throat occurred less in group A than those in group B. Anesthesia expense in group A was significantly lower than that in group B. Conclusion Single-lumen tracheal tube anesthesia and apneic ventilation used in thoracoscopic sympathectomy has the advantages of easy intubation, safety, less complication and expense.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2009年第4期309-311,共3页
Journal of Clinical Anesthesiology
