保留自主呼吸喉罩麻醉用于单孔电视胸腔镜下肺大泡切除术的效果观察  

Spontaneous breathing with laryngeal mask airway in endotracheal intubation anesthesia for thoracoscopic lung bullae resection

作　　者：赵伟军[1] 周成伟[1] 朱勇刚[1] 朱斌斌[1] 赵晓东[1] ZHAO Weijun;ZHOU Chengwei;ZHU Yonggang(Department of Thoracic Surgery,Affiliated Hospital of Ningbo University Medical College,Ningbo 315020,China)

机构地区：[1]宁波大学医学院附属医院胸外科

出　　处：《浙江医学》2019年第20期2208-2210,2214,共4页Zhejiang Medical Journal

摘　　要：目的 探讨保留自主呼吸喉罩麻醉下行胸腔镜肺大泡切除术的安全性和可行性.方法 将60例因肺大泡破裂致自发性气胸患者保留自主呼吸喉罩麻醉单孔电视胸腔镜手术(NIVATS)28例和双腔气管插管单肺通气单孔电视胸腔镜(OVL)手术32例,比较两组患者的麻醉准备时间、手术时长、术中出血量,术中平均血氧饱和度(SpO2)、复苏时间、术后引流量、住院时间、住院费用、咽喉不适情况.结果 NIVATS组麻醉准备时间(16.3±5.2)min、复苏时间(12.3±4.5)min、住院时间(2.5±1.0)d、住院费用(2.13±0.21)万元、咽喉不适(3.6%)低于OVL组[(33.2±6.3)min、(31.2±8.6)min、(3.5±1.2)d、(2.56±0.32)万元、28.2%],差异均有统计学意义(均P<0.05).结论 NIVATS单孔肺大泡切除术是安全可行的,值得在临床上推广.Objective To investigate the safety and feasibility of preservation of spontaneous breathing with laryngeal mask in endotracheal intubation anesthesia for thoracoscopic lung bullae resection.Methods Sixty patients with lung bullae underwent single-channel video-assisted thoracoscopic resection;including 32 patients with spontaneous breathing by using laryngeal mask anesthesia(NIVATS group)and 28 patients receiving double-lumen endotracheal intubation with single-lung ventilation(OVL group).The preparation time,operation time,intraoperative blood loss,intraoperative average SPO2,recovery time,postoperative drainage,length of hospital stay,hospitalization expenses,and throat discomfort were compared between two groups.Results The anesthesia preparation time(16.3±5.2min vs.33.2±6.3min),recovery time(12.3±4.5min vs.31.2±8.6min),length of hospital stay(2.5±1.0d vs.3.5±1.2d),hospitalization cost(21.3±2.1 thousand Yuan vs.25.6±3.2) thousand Yuan,and the rate of throat discomfort(3.6%vs.28.2%)in NIVATS group were significantly lower than those in OVL group(all P<0.05).Conclusion NIVATS pulmonary bullous resection is safe and feasible and worthy of promotion in clinical use.

关 键 词：保留自主呼吸麻醉 自发性气胸 肺大泡 单孔胸腔镜 

分 类 号：R47[医药卫生—护理学]