单腔气管插管麻醉在胸腔镜下双侧胸交感神经链部分切除治疗手汗症中效果分析  

Effect of single-lumen endotracheal intubation on thoracoscopical partial resection of bilateral sympathetic chain for palmar hyperhidrosis

作　　者：安鲁毅[1] 林善昌[2] 

机构地区：[1]福州市第一医院麻醉科,350007 [2]福建医科大学附属第二医院胸心外科,福建泉州362000

出　　处：《中华实用诊断与治疗杂志》2016年第3期284-286,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：泉州科技局课题(2011Z45)

摘　　要：目的探讨单腔气管插管麻醉在胸腔镜下双侧胸交感神经链部分切除术中的麻醉效果。方法 59例手汗症患者,单腔气管插管麻醉下行电视胸腔镜下双侧胸交感神经链部分切除术,术中采用小潮气量通气配合短暂停止通气模式维持呼吸,观察麻醉效果,并监测麻醉诱导前(T1)、钻孔前(T2)、切断一侧胸交感神经即刻(T3)、完成缝合入镜孔即刻(T4)、切断另一侧胸交感神经即刻(T5)、缝合切口后即刻(T6)及麻醉苏醒拔管后6 min(T7)患者平均动脉压(mean arterial pressure,MAP)、心率、脉搏血氧饱和度(pulse oxygen saturation,SpO2)和呼气末二氧化碳分压(end-tidal carbon dioxide partial pressure,PETCO2)变化。结果所有患者均气管插管顺利、麻醉效果满意;各时间点MAP、心率、SpO2比较差异均无统计学意义(P>0.05),仅T5时患者PETCO2[(5.20±1.04)kPa]高于T1时[(4.29±0.78)kPa](P<0.05),其余时间点PETCO2比较差异无统计学意义(P>0.05)。结论单腔气管插管麻醉用于胸腔镜下双侧胸交感神经链部分切除术安全、可行。Objective To explore the anesthetic effect of single-lumen endotracheal intubation on thoracoscopical partial resection of bilateral sympathetic chain for palmar hyperhidrosis. Methods Fifty-nine patients with palmar hyperhidrosis received thoracoscopical partial resection of bilateral sympathetic chain under single-lumen endotracheal intubation. During the operation, the patients received small-tidal volume ventilation combined with breathholding. The changes of mean arterial pressure, heart rate, pulse oxygen saturation and end-tidal carbon dioxide partial pressure were monitored at the time points of before anesthesia induction （T1）, before drilling （T5）, instantly after cutting off one side of thoracic sympathetic nerve （T3）, instantly after suturing the incision （T4）, instantly after cutting off the other side of thoracic sympathetic nerve （T6）, instantly after suturing the incision （T6） and 6 minutes after extubation during anesthesia （T7） to evaluate the anesthetic effect. Results Endotracheal intubation was smoothly completed and anesthesia effect was satisfactory. There were no significant differences in mean arterial pressure, heart rate and pulse oxygen saturation among different time points （P〉0.05）. End-tidal carbon dioxide partial pressure was significantly higher at T5 （（5.20 ± 1.04） kPa） than that at T1 （（4.29 ± 0.78） kPa） （P〈0.05））, and showed no significant differences among the other time points （P〉0.05）. CoIlclusion Anesthesia with single-lumen endotracheal intubation is safe and practical for thoracoseopical partial resection of bilateral sympathetic chain for palmar hyperhidrosis.

关 键 词：手汗症 胸交感神经干切断术 胸腔镜 气管插管 单腔 麻醉 

分 类 号：R614[医药卫生—麻醉学]