周围体外循环在气管插管困难手术中的应用  

Application of peripheral cardiopulmonary bypass in the operation with difficult tracheal intubation

作　　者：汪源[1] 周曼玲[1] 邹艳[1] 黄飞[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院心脏大血管外科,湖北武汉430030

出　　处：《安徽医药》2016年第10期1882-1884,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨周围体外循环在气管插管困难手术中应用的可行性和适应证,总结应用中的经验教训。方法收集8例气管插管困难患者,其中气管肿瘤5例,气管内肉芽肿1例,巨大甲状腺肿2例。均予以周围体外循环辅助,于术前局麻下股动脉、股静脉插管建立体外循环,切除肿瘤或处理完气管病变后,气管插管可通过狭窄段,重建气管通路后停止转流。结果体外循环转流时间(58.00±17.34)min;体外循环转流过程中脑氧饱和度最低值68.25%±4.49%,全部在正常范围;体外循环停机均顺利,并安全完成手术;全部患者随访3个月,无1例死亡,未发生体外循环相关并发症。结论周围体外循环技术可提供安全可行的呼吸循环辅助方式,利于各种原因造成的气管插管困难患者安全顺利完成手术。Objective To explore the feasibility and indications of the application of peripheral cardiopulmonary bypass in patients with difficult tracheal intubation,and to summarize the experience and lessons in the application. Methods A total of 8 cases with difficult tracheal intubation was collected,male 4 cases,female 2 cases. There were 5 cases of tracheal tumor,1 case of tracheal granuloma,and 2 cases of huge goiter. In preoperative anesthesia femoral artery and femoral vein intubation cardiopulmonary bypass was established. After the resection of tumor or dealing with tracheal lesions,tracheal intubation can be through the stricture and stop bypass after reconstruction of tracheal pathway. Results Cardiopulmonary bypass flow time was（ 58. 00 ± 17. 34） min; the lowest values of cerebral oxygen saturation during the cardiopulmonary bypass process（ 68. 25 ± 4. 49） % were all within the normal range. extracorporeal circulation stopped smoothly,and the operation was successful. All the cases were followed up for 3 months. There was no death or cardiopulmonary bypass related complication. Conclusions Peripheral extracorporeal circulation technique can be used to provide a safe and feasible method to aid cardiopulmonary circulation for the patients with difficult tracheal intubation.

关 键 词：气管插管 周围体外循环 气管肿瘤 

分 类 号：R614[医药卫生—麻醉学]