同期双侧肺手术的麻醉处理  

Anesthetic treatment during bilateral pulmonary surgery at the same period

作　　者：马宏伟[1] 耿恩江[1] 李凤茹[1] 杨永斌[1] 丁丽景[1] 

机构地区：[1]河北省胸科医院麻醉科,石家庄市050041

出　　处：《河北医药》2011年第19期2908-2910,共3页Hebei Medical Journal

摘　　要：目的探讨同期双侧肺部手术的麻醉管理方法,评价其应用效果。方法对2005年5月至2010年6月双侧肺部病变同期手术治疗的患者132例,麻醉前的评估、双腔支气管导管的选择、术中呼吸循环的管理、麻醉苏醒期的处理、术后镇痛等方面进行回顾分析。结果 132例同期双侧肺手术均成功完成,手术时间平均192min,其中单肺通气时间平均135min,无机械通气并发症的发生。术中根据各项监测结果及时调整患者各项生理指标维持在正常范围。术毕苏醒拔管时间平均18min,术后随访,所有患者无围手术期麻醉并发症发生,术后顺利恢复出院。结论通过采取一些有效的麻醉处理方法,双侧肺同期手术患者可安全度过围手术期。Objective To investigate the anesthetic method during bilateral pulmonary surgery at the same period and to evaluate its application effect. Methods The clinical data of 132 patients admitted from May 2005 to June 2010 who were operated for bilateral pulmonary pathological changes at the same period were retrospectively analyzed, which included the assessment before anesthesia, the choice of double-lumen endobronchial tube （ DLT）, the management of respiration and blood circulation during the operation, the treatment during analepsia and postoperative analgesia. Results The 132 cases of bilateral pulmonary surgery were completed successfully ,with average operation time being 192 min in which one-lung ventilation time was 135 min, without occurrence of mechanical ventilation complications. During the operation, patients＂ physiological indexes were kept within normal range. The extubation time was average 18 rain after the operation,according to the results of follow-up after operation, all the patients had no complications at peroperative period, and all the patients recovered completely and left hospital. Conclusion The patients who are going to undergo bilateral pulmonary surgery at the same period are able to live through safely the peroperative period by adopting some effective anesthesia ways.

关 键 词：肺切除术 麻醉 通气模式 导管插入术 外周 呼吸 

分 类 号：R64[医药卫生—外科学]