局部麻醉自主呼吸下一期双侧胸腔镜胸交感神经夹闭术  

One stage bilateral thoracoscopic sympathetic blocking under local infiltration anesthesia:A report of thirteen cases

作　　者：郭绍红[1] 储修峰[1] 张晓辉[1] 严金[1] 陈江[1] 王晶晶[2] 王孝文[3] 

机构地区：[1]中国医科大学绍兴华宇医院微创外科,浙江绍兴312030 [2]中国医科大学绍兴华宇医院心理咨询与心理治疗门诊,浙江绍兴312030 [3]中国医科大学绍兴华宇医院麻醉科,浙江绍兴312030

出　　处：《中国医学工程》2007年第12期954-957,共4页China Medical Engineering

摘　　要：目的探讨局部麻醉下行一期双侧胸腔镜胸交感神经夹闭术的可能性。方法多汗症或颜面潮红患者自己选择麻醉方式。全身麻醉组54例,15～50岁;局部麻醉组13例,18～45岁。局部麻醉组每个切口用1%利多卡因10mL进行局部浸润麻醉,进行常规一期双侧胸腔镜胸交感神经夹闭术。结果局部麻醉组患者整个手术过程中神智完全清醒,完全自主呼吸。局部麻醉组和全身麻醉组的手术时间分别为(56.92±14.51)min和(42.41±12.16)min(P<0.01)。术毕至出手术室时间两组分别为(10.77±9.54)min和(25.28±11.34)min(P<0.01),局部麻醉组住院时间较少(P=0.01),手术费用较少(P<0.01)。结论一期双侧胸腔镜胸交感神经夹闭术可以在局部浸润麻下完成。局部麻醉手术消除了全身麻醉的各种风险,更为微创、费用显著减少、术后恢复加快、住院日显著缩短。[Objective] To investigate the possibility of performing the operation of one stage bilateral thoracoscopic sympathetic blocking （OSBTSB） under local infiltration anesthesia and spontaneous breathing. [Methods] 67 patients of hyperhidrosis or facial blushing were involved in this study. The methods of general anesthesia （GA） or local infiltration anesthesia （LIA） were chosen by patients. There were 54 patients in group of general anesthesia （GGA）, aged 15 to 50 （mean 28.81 years） and 13 in group of local infdtration anesthesia （GLIA）, aged 18 and 45 （mean 26.62 years）. The HA of each of the four incisions was made by injecting 10ml of 1% lidocaine. OSBTSB were performed according to the routine method, which was the same as GA. [Results] All patients in GLIA were consciousness and breathed spontaneously during the operation. The operation time were （56.92±14.51） min for GLIA and （42.41±12.16） min for GGA （P〈0.01）. The time between entering and coming out of the operation room were （101.54±22.49） min for GLIA and （106.48±25.13） min for GGA （P 〉0.05）. The time between finishing of the operation and coming out of operation room were （10.77±9.54） rain for GLIA and （25.28±11.34） min for GGA （P 〈0.01）. The hospitalization days were （3.38-±0.77） days for GLIA and （3.89±0.57） days for GGA （P=0.01）. The cost were （5388.10±1128.69） yuan for GLIA and （6800.66±897.88） yuan for GGA （P〈0.01）. [Conclusion] The operation of OSBTSB can be successfully and safely performed under LIA. All the risk of GA can be avoided if the operation performed under LIA. The superiority are more safe, smaller invasion, more cheap, faster recovering and shorter hos-pital stay with that of the operation under GA.

关 键 词：胸交感神经夹闭术 胸腔镜 

分 类 号：R655[医药卫生—外科学]