临床研究喉罩全麻与气管插管全麻胸腔镜手术治疗肺大疱的临….pdfVIP

·756 · doi 10.3969/j.issn. 1673-4254.2013.05.26 J South Med Univ, 2013, 33(5): 756-760 临床研究 喉罩全喉罩全麻与气管插管全麻胸腔镜手术治疗肺大疱的临床对照研麻与气管插管全麻胸腔镜手术治疗肺大疱的临床对照研究究 1 1 2 1 3 3 1 1 蔡开灿 ，王向东 ，叶 靖 ，刁定伟 ，何建行 ，刘 君 ，黄志勇 ，吴 华 1 2 3 南方医科大学南方医院 心胸血管外科，麻醉科，广东 广州 510515 ；广州医学院第一附属医院胸外科，广东 广州 510120 摘要：目的评估喉罩全麻小潮气量高频双肺通气胸腔镜手术治疗肺大疱的可行性和安全性。方法 试验组与对照组各30 例肺 大疱患者。试验组在喉罩小潮气量高频双肺通气全麻下行胸腔镜手术；对照组在双腔气管插管全麻单肺通气下进行胸腔镜手 术。结果 喉罩组与插管组在麻醉和手术时间、最低氧饱和度、最高呼末二氧化碳分压、术野和麻醉满意度、失血量无明显差 异。喉罩组手术前后白细胞、中性粒细胞百分比升高程度明显低于插管组，术后清醒时间、开始进食时间、下地时间、术后住院 时间和引流时间均比插管组短；喉罩组胃肠道反应、咽部不适、声嘶发生率也低于对照组。结论 喉罩全麻胸腔镜手术治疗肺大 疱具有良好的可操作性和安全性。 关键词：喉罩；气管内插管；胸腔镜；肺大疱 Laryngeal mask anesthesia in video-assisted thoracoscopic surgery for pulmonary bulla: comparison with intubation anesthesia 1 1 2 1 3 3 1 1 CAI Kaican , WANG Xiangdong , YE Jing , DIAO Dingwei , HE Jianxing , LIU Jun , HUANG Zhiyong , WU Hua 1Department of Thoracic Surgery, 2Department of Anesthesia, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; 3Department of Thoracic Surgery, First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510120, China Abstract: Objective To assess the feasibility and safety of thoracoscopic bulla resection under laryngeal mask anesthesia with low tidal volume high-frequency lung ventilation. Methods Sixty patients with pulmonary bulla were randomized into two groups (n=30) to undergo video-assisted thoracoscopic surgery (VATS) for bulla resection with laryngeal mask anesthesia and high-frequency low tidal volume lung ventilation general anesthesia and or with intubation anesthesia and one-lung ventilation through double-lumen endotracheal intubation. Results No significant differences were