胸腔镜交感神经切断术不同气管插管麻醉的前瞻性研究  

A prospective study of single versus double-lumen intratracheal intubation for needle video-assisted thoracoscopic T3~4 sympathectomy in palmar hyperhidrosis

作　　者：李昀[1] 程楠[2] 何锦园[1] 黄邵洪[1] 安军[1] 张军航[1] 

机构地区：[1]中山大学附属第三医院心胸外科,广东广州510630 [2]中山大学附属第三医院麻醉科,广东广州510630

出　　处：《中国内镜杂志》2015年第6期620-623,共4页China Journal of Endoscopy

基　　金：中山大学"985"工程项目(82000-31101301)

摘　　要：目的比较单腔或双腔气管插管麻醉在手汗症患者行针形胸腔镜(VATS)双侧T3、4交感神经链切断术中的安全性、可行性及成本效益优势。方法前瞻性研究2013年7月-2013年12月于该科行针形VATS双侧T3、4交感神经链切断术的40例手汗症患者,随机分成两组,每组20例,分别采用单腔气管插管麻醉或双腔气管麻醉。比较两组的插管时间、手术时间、住院天数、麻醉费用及住院费用,术后30 d随访两组的手汗缓解及代偿性多汗情况。结果两组困难插管率、手术时间、住院时间、并发症发生率、手汗缓解率及代偿性多汗发生率差异均无显著性(P>0.05)。单腔气管插管组插管时间[(6.85±1.50)vs(14.70±3.31)min,t=9.664,P=0.000)]、麻醉费用[(3 028.65±252.60)vs(4 055.25±259.60)元,t=12.675,P=0.000)]及手术费用[(8 380.75±339.70)元vs(9 468.85±420.39)元,t=9.003,P=0.000]均明显低于双腔气管插管组,差异有显著性(P<0.05)。结论单腔或双腔气管插管麻醉对于针形VATS双侧T3、4交感神经链切断术均安全、可行。单腔插管与双腔插管相比,能有效缩短插管时间,具有较好的成本效益优势。【Objective】To compare the safety, feasibility and cost-effectiveness of single or double-lumen intratracheal intubation anesthesia for needle video-assisted thoracoscopic（VATS） T3 ~4 sympathectomy in palmar hyperhidrosis. 【Methods】 Forty consecutive palmar hyperhidrosis patients who underwent needle VATS T3 ~4sympathectomy between July 2013 and December 2013 in a single center were included in this study. Forty patients were divided into single-lumen intratracheal intubation group（n =20） and double-lumen intratracheal intubation group（n =20） using computer-generated random number table. The time of intubation, operation, hospital stay,anesthesia cost and hospital cost were recorded. All patients were followed up at thirty days after operation.【Results】There was no difference between two groups in terms of age, sex, disease duration, weight, height, BMI and family history（P〉0.05）. Patients who underwent single-lumen intratracheal intubation had a shorter time of intubation（6.85±1.50） min vs.（14.70±3.31） min, t =9.664, P =0.000）, lower anesthesia cost（3028.65±252.60） yuan vs.（4055.25±259.60） yuan, t =12.675, P =0.000） and hospital cost（8380.75±339.70） yuan vs.（9468.85±420.39）yuan, t =9.003, P =0.000） compared to the double-lumen intratracheal intubation group. No statistically significant differences were observed between the difficult intubation, operation time, hospital stay, complication, remission rate and compensatory hyperhidrosis. 【Conclusion】Both single and double-lumen intratracheal intubation for needle VATS T3 -4 sympathectomy are safe and feasible. Single-lumen intubation has short intubation time and better cost-effectiveness compared to double-lumen intubation.

关 键 词：胸腔镜 气管插管 多汗症 交感神经链切断术 

分 类 号：R655.5[医药卫生—外科学] R651.4[医药卫生—临床医学]