胸腔镜食管癌根治术中人工气胸与双腔插管临床应用对比分析  

Clinical differences between artificial pneumothorax and double lumen intubation in thoracoscopic esophagectomy

作　　者：尹哲[1] 綦俊[1] 

机构地区：[1]重庆市肿瘤研究所胸外科,重庆400030

出　　处：《局解手术学杂志》2016年第2期125-127,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨胸腔镜食管癌根治术采用双腔气管插管和人工气胸单腔插管2种不同插管方法之间的利与弊。方法2014年1月至2015年4月我院胸外科收治90例行胸腔镜食管癌根治术患者,按插管方法的不同分为人工气胸组(A组)和双腔插管组(B组),将2组的气管插管时间、手术时间、肺部感染发生率、术中及术后PaO_2和PaCO_2、吻合口瘘发生率、住院费用、住院时间、术后乳糜胸发生率等进行比较。结果 2组患者术中PaO_2和Pa CO_2、肺部感染发生率、气管插管时间、手术时间、住院时间及住院费用等比较,差异有统计学意义(P<0.05)。结论胸腔镜食管癌根治术中人工气胸单腔插管在围手术期管理、费用等方面有一定优势,但是对低氧血症、CO_2潴留及酸碱平衡紊乱等的处理,双腔插管更有优势。Objective To explore the advantages and disadvantages of the double lumen endotracheal intubation and single-lumen endotracheal intubation and continuous carbon dioxide insufflation in thoracoscopic esophagectomy. Methods The clinical data of 90 patients in our department of thoracic surgery after thoracoscopic esophagectomy from January 2014 to April 2015 were analyzed. All patients were divided into single-lumen endotracheal intubation（ group A） and double lumen endotracheal intubation group（ group B）. The endotracheal intubation time,operation time,incidence of pulmonary infection,intraoperative and postoperative PaO2,PaCO2,incidence of anastomotic fistula,hospitalization expenses,length of hospital stay and the incidence of postoperative chylothorax between two groups were compared. Results The difference in intraoperative PaO2,Pa CO2,incidence of pulmonary infection,endotracheal intubation time,operation time,hospitalization days and the hospitalization cost between two groups were statistical significance. The difference of the rest index between two groups were no statistical significance. Conclusion Group A has certain advantages in perioperative management,hospitalization cost and so on,but has disadvantages in perioperative hypoxemia and carbon dioxide retention and acid-base balance disorders.

关 键 词：胸腔镜食管癌切除术 人工气胸单腔插管 双腔插管 

分 类 号：R739.6[医药卫生—肿瘤]