摘要
目的:比较非气管插管与双腔气管插管全身麻醉下行胸腔镜肺大泡切除术的临床效果。方法:选取2018年1-10月于广西壮族自治区人民医院行单孔胸腔镜下肺大泡切除术患者70例,按随机数字表法分为观察组和对照组,每组35例。观察组保留自主呼吸面罩吸氧下行超声引导下前锯肌平面阻滞复合静脉麻醉,对照组采用双腔气管插管全麻。比较两组围术期相关指标及术后并发症发生率。结果:所有患者均顺利完成手术。与对照组比较,观察组术毕清醒时间和术后住院时间缩短,术后VAS评分和总并发症发生率降低,术中全麻药(丙泊酚、瑞芬太尼、舒芬太尼)用量及住院费用明显减少,手术开始后30 min及手术结束时动脉血二氧化碳分压(PaCO2)明显升高(均P<0.05)。结论:非气管插管自主呼吸全麻辅助超声引导下区域神经阻滞行肺大泡切除术可提高患者舒适度,缩短患者苏醒时间及术后住院时间,减少全麻药用量及术后并发症发生。
Objective:To compare the clinical effect of non-tracheal intubation and double-lumen endotracheal tube general anesthesia in thoracoscopic resection with bullae of lung.Methods:A total of 70 patients who underwent single hole thoracoscopic resection of lung bullae in our hospital from January 2018 to October 2018 were selected,and randomly divided into an observation group and a control group,with 35 cases in each group.Patients in the observation group received non-tracheal intubation general anesthesia,and those in the control group received double-lumen endotracheal tube general anesthesia.The perioperative related indexes and postoperative complications were observed and compared.Results:All patients successfully completed the operation.Compared with the control group,the awaking time,postoperative hospital days,VAS score and the incidence of total complications,the use of propofol,remifentanil and sufentanil during operation,and hospitalization expenses were decreased in the observation group,while the partial pressure of carbon dioxide(PaCO2)in arterial blood was significantly increased at 30 min post-operation and at the end of operation(P<0.05).Conclusion:Non-tracheal intubation general anesthesia assisted ultrasound-guided costoscapularis plane block application in thoracoscopic pulmonary bullae resection could improve the comfort of patients,shorten recovery time and postoperative hospital days,and reduce the dosage of general anesthetics and the incidence of postoperative complications.
作者
刘小青
周一凡
黄爱兰
马利
于美钢
唐学锋
Liu Xiaoqing;Zhou Yifan;Huang Ailan;Ma Li;Yu Meigang;Tang Xuefeng(Department of Anesthesiology,The People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China;不详)
出处
《广西医科大学学报》
CAS
2019年第10期1597-1601,共5页
Journal of Guangxi Medical University
基金
广西医疗卫生适宜技术研究与开发课题资助项目(No.S201549)
关键词
非气管插管全麻
自主呼吸
肺大泡切除
单孔胸腔镜手术
non-intubation general anesthesia
spontaneous breathing
pulmonary bullae resection
single hole thoracoscopic surgery
