微创腋下切口心内直视手术的麻醉管理探讨  

Anesthesic Management of Cardiac Surgery Through a Minimal Right Vertical Infra Axillary Thoraeotomy

作　　者：韦华[1] 邓劲松[1] 张日英[1] 李波[1] 

机构地区：[1]高州市人民医院麻醉科,广东高州525200

出　　处：《中国实用医药》2006年第1期13-15,共3页China Practical Medicine

摘　　要：目的探讨微创腋下切口心内直视手术的麻醉管理方法。方法214例施行腋下小切口手术病人,插管全麻,中小剂量芬太尼镇痛,维库溴铵维持肌松,辅以低浓度的异氟醚吸入、分次静注异丙酚等方法维持麻醉。结果全组病人均顺利出院,术后再次开胸止血3例,肺不张8例,与同期常规正中开胸组相比,呼吸支持时间、术后胸液量、输血量、术后住院时间明显缩短(P<0.01)。结论术中加强肺保护、减少肺损伤、注意循环功能维护是微创腋下切口心内直视手术麻醉成功的必要条件,也是微创手术创伤小、恢复快的特点得以发挥的重要保证。Objective To discuss the anesthesic management of cardiac surgery through a minimal right vertical infra axillary thoracotomy.Methods 214 patients, Anesthesia was maintained with intravenous vecuronium continuously by pump, intermitted intravenous fentanyl and supplemented with isoflurane inhalation.Results There was no postoperative deaths. Three cases need secondary thoracotomy and hemostasis, Eight the lung not open enough, mediam sternotomy at the same period The ventilation, the volume of drainage, the amount of blood transfusion and hospital day were significantly less （P〈0.01）.Conclusion Add protecting of lung and assure the data of hemodynamics satisfied and postoperative analgesia are the key factors to improve cardiac surgery outcome.

关 键 词：全麻 腋下切口 心内直视手术 

分 类 号：R614[医药卫生—麻醉学]