非气管内插管自主呼吸麻醉下电视胸腔镜手术治疗纵隔肿瘤62例临床分析  

The Clinical Analysis of Video-assisted Thoracoscopic Surgery in 62 Cases of Mediastinal Tumor by Spontaneous Breathing under Intravenous Anesthesia

作　　者：张鑫[1] 郭志华[1] 李京沛[1] 黄伟哲[2] 

机构地区：[1]广州医科大学附属第一医院,广东广州510120 [2]汕头大学医学院

出　　处：《中国医学创新》2017年第22期1-5,共5页Medical Innovation of China

基　　金：广州市科技计划项目(2011Y2-00024)

摘　　要：目的:探讨非气管内插管自主呼吸麻醉下电视胸腔镜手术(VATS)治疗纵隔肿瘤可行性与安全性。方法:回顾性分析2011年12月-2017年3月在本院进行VATS手术治疗的纵隔肿瘤患者124例,根据不同的手术方法分为试验组与对照组,每组各62例。试验组采用非气管内插管自主呼吸胸腔镜下纵隔肿瘤切除术,对照组同期采用双腔管气管内插管全麻下行VATS手术治疗,比较两组患者的围术期相关指标以及术后并发症发生率。结果:两组患者手术均顺利,无术中或术后死亡。两组手术患者的手术时间、术中出血量、术后住院时间比较差异无统计学意义(P>0.05)。术后早期下床活动时间、进食时间,术后咽喉疼痛、刺激性干咳等并发症发生率显著低于对照组(P<0.05)。结论:非气管内插管自主呼吸麻醉下VATS治疗纵隔肿瘤是可行性与安全的,有利患者术后的快速康复,减少术后并发症,值得临床推广应用。Objective： To investigate the clinical curative effect of mediastinal tumor resection under thoracoscope in the treatment of mediastinal tumor by spontaneous breathing under intravenous anesthesia. Method： The clinical data of 124 patients with mediastinum tumor in our hospital from December 2011 to March 2017 were retrospective analyzed and divided into two groups according to the different operation method, 62 cases in each group.The control group was given traditional video-assisted thoracic surgery （ VATS ） mediastinal tumor resection under endotracheal tube anesthesia, while the experimental group was performed VATS mediastinal tumor resection by spontaneous breathing under intravenous anesthesia.The difference of operation time, intra- operative blood loss, postoperative ambulation time, postoperative feeding time, pharyngodynia, irritable cough, length of hospital stay and postoperative complications between the two groups were compared.Result： Two groups of patients were operated successfully, without intraoPerative or postoperative death.The differences were no statistically significant in the operation time, intraoperative blood loss, and length of hospital stay of two groups （ P〈0.05 ） .The postoperative ambulation time and postoperative feeding time, pharyngodynia and irritable cough in experimental group were better than those of control group （ P〈0.05 ） .Conclusion： The VATS mediastinal tumor resection by spontaneous breathing under intravenous anesthesia are feasibility and safety in selected patiens.It has curative clinical effect for mediastinal tumor with patients recover quickly and fewer complications, less surgical trauma, it is more worthy of clinical application.

关 键 词：纵隔肿瘤 电视胸腔镜手术 自主呼吸麻醉 

分 类 号：R734.5[医药卫生—肿瘤]