胸椎旁置管阻滞复合保留自主呼吸的非气管插管麻醉在胸腔镜手术中的应用  

Application of Thoracic Paravertebral Intubation Block Combined with Non Endotracheal Intubation Anesthesia with Spontaneous Respiration in Thoracoscopic Surgery

作　　者：蔡东妙[1] 王庆祥[1] 汪海松[1] CAI Dongmiao;WANG Qingxiang;WANG Haisong(The First Affiliated Hospital of Xiamen University,Xiamen 361003,China;不详)

机构地区：[1]厦门大学附属第一医院,福建厦门361003

出　　处：《中外医学研究》2020年第29期144-146,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析胸腔镜手术中应用胸椎旁置管阻滞复合保留自主呼吸的非气管插管麻醉的临床应用价值。方法:本研究将对本科临床入选(2018年9月-2019年12月)的60例胸腔镜手术患者运用随机数表法分为对照组(n=30,行气管插管麻醉)和观察组(n=30,行胸椎旁置管阻滞复合保留自主呼吸的非气管插管麻醉)。比较两组麻醉前和麻醉30 min后心率(HR)、平均动脉压(MAP)、动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)和手术指标。结果:麻醉前两组患者HR、MAP、PaO2、PaCO2比较差异均无统计学意义(P>0.05);麻醉30 min后,两组HR均升高,观察组低于对照组,差异有统计学意义(P<0.05);麻醉30 min后,对照组MAP、PaO2升高,观察组MAP、PaO2降低,差异有统计学意义(P<0.05),对照组麻醉前和麻醉30 min后PaCO2差异无统计学意义(P>0.05),观察组麻醉30 min后PaCO2较对照组麻醉30 min后高(P<0.05)。两组住院时间、术后下床活动时间、手术时间等手术相关指标比较,观察组均较优于对照组,差异有统计学意义(P<0.05)。结论:胸腔镜手术中应用胸椎旁置管阻滞复合保留自主呼吸的非气管插管麻醉具备良好临床作用,改善了患者的临床状态,缩短了住院时间。Objective:To analyze the clinical application value of thoracic paravertebral intubation block combined with non endotracheal intubation anesthesia with spontaneous respiration in thoracoscopic surgery.Method:In this study,60 cases of thoracoscopic surgery were selected in our department(from September 2018 to December 2019)and randomly divided into the control group(n=30,tracheal intubation anesthesia)and the observation group(n=30,thoracic paravertebral intubation block combined with non endotracheal intubation anesthesia with spontaneous respiration).Heart rate(HR),mean arterial pressure(MAP),arterial oxygen partial pressure(PaO2),carbon dioxide partial pressure(PaCO2)before and 30 minutes after anesthesia and operation indexes were compared between the two groups.Result:There were no significant differences in HR,MAP,PaO2 and PaCO2 between the two groups before anesthesia(P>0.05).HR of the two groups increased 30 minutes after anesthesia,while that of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).MAP and PaO2 of the control group increased 30 minutes after anesthesia,while MAP and PaO2 of the observation group decreased,the differences were statistically significant(P<0.05).The difference of PaCO2 between the control group before and 30 min after anesthesia was not statistically significant(P>0.05).PaCO2 in the observation group was higher than that in the control group 30 min after anesthesia(P<0.05).Compared with the control group,the observation group were better than the control group in terms of operative indicators such as length of stay,postoperative ambulation time and time of operation,and the differences were statistically significant(P<0.05).Conclusion:The application of thoracic paravertebral intubation block combined with non tracheal intubation anesthesia with preservation of spontaneous breathing has good clinical effect in thoracoscopic surgery,which improves the clinical status of patients and shortens the hospitalization t

关 键 词：胸椎旁置管阻滞 保留自主呼吸 非气管插管麻醉 胸腔镜手术 

分 类 号：R614[医药卫生—麻醉学]