非开胸胃肠组织重建食管手术的麻醉特点  

Anaesthesia for esophageal reconstruction witk abdom-inal viscera in non-thoractomy

作　　者：杨文芳[1] 杨萍[1] 刘雄华[1] 唐平章[1] 陈默启[1] 李进让[1] 杨海良[1] 

机构地区：[1]中国医学科学院肿瘤医院麻醉科,中国医学科学院肿瘤医院头颈外科

出　　处：《中华外科杂志》1995年第8期463-465,共3页Chinese Journal of Surgery

摘　　要：对１９８３～１９９４年１３９例因下咽癌或颈段食管癌行全喉全下咽切除、食管内翻剥脱、食管重建手术病例的麻醉特点进行了总结。作者认为：（１）下咽癌、颈段食管癌存在着潜在的呼吸困难，正确选择麻醉插管方式，可提高麻醉插管的成功率。（２）本组非开胸纵隔操作时，６６例（４７．５％）患者血压下降＞３ｋＰａ，２７例（１９．４％）发生心律失常。术前、术中的妥善处理，可控制其变化程度。（３）分离食管时，本组２例发生气管膜样部撕裂，对此应予以重视。（４）保证有效的呼吸，维持稳定的循环是手术麻醉的关键。AbstractRadical resection of carcinoma of the hyopharynxand cervical esophagus usually involves pharyngo-laryngo-esophagectomy and esophaged reconstructionwith stomach or colonic replacement.From 1983 to1994,139 patients underwent the operations in ourhospital.Although no thoracotomy,the extensive in-volvement of the neck,thorax and abdomen in the op-eration made the anesthesia difficult,There were 66 patients whose blood pressure dropped more than 3kPa in the course of trans-mediastinum extraction of esophagus and gastric pull-up.There were injury ofposterior wall of trachea in 2 patients and spleen rup-ture in 3.However,no anesthetic complications oc-curred during the operation.

关 键 词：麻醉 食管肿瘤 食管重建 

分 类 号：R655.4[医药卫生—外科学] R735.105[医药卫生—临床医学]