胸腔镜辅助心房纤颤射频消融术的麻醉处理  

Preoperative Management of Video-assisted Thoracoscopic Radiofrequency Ablation for Atrial Fibrillation

作　　者：林多茂[1] 刘晓明[1] 闫旭明[1] 卢家凯[1] 卿恩明[1] 

机构地区：[1]首都医科大学附属北京安贞医院麻醉科,北京100029

出　　处：《中国微创外科杂志》2010年第7期584-586,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨胸腔镜辅助心房纤颤射频消融术的麻醉处理方法。方法 2006年12月～2009年2月,行胸腔镜辅助心房纤颤射频消融术159例,采用全凭静脉麻醉,双腔气管插管,根据手术需要先后行左侧和右侧单肺通气。结果本组无围手术期死亡,手术时间(162±22)min(132～243min),手术失血量(85±23)ml(70～200ml),术后住院(7.6±2.4)d(6～11d)。3例术后因低氧血症而再次气管插管,1例因术后急性心功能不全行主动脉内气囊反搏(IABP)辅助,无麻醉并发症。结论全凭静脉麻醉,术中密切监测,完善的单肺通气管理和循环管理是胸腔镜辅助心房纤颤射频消融术成功的关键。Objective To study the anesthesia management of video-assisted thoracoscopic radiofrequency ablation for the treatment of atrial fibrillation. Methods From December 2006 to February 2009,159 patients received video-assisted thoracoscopic radiofrequency ablation under general intravenous anesthesia and single-lumen intubation in our hospital. Right or left side one-lung ventilation was performed during the operation. Results No peri-operative death occurred in our series,the mean operation time was （162±22） min （ranged from 132 to 243 min）,and intra-operative blood lose was （85±23） ml （ranged 70-200 ml）. The patients were discharged from hospital in 6 to 11 days [mean,（7.6±2.4） d] after the operation. After the surgery,3 patients developed postoperative anoxia and thus underwent re-intubation,1 patient received IABP because of acute cardiac dysfunction. No anesthesia-related complications were found in our patients. Conclusions General intravenous anesthesia,close monitoring,and complete one-lung ventilation and circulation management are key steps for the success of video-assisted thoracoscopic radiofrequency ablation for atrial fibrillation.

关 键 词：麻醉 胸腔镜 心房纤颤 射频消融 

分 类 号：R614.2[医药卫生—麻醉学]