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.pdf

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例临床分析目的：探討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。标签：纵隔肿瘤；电视胸腔镜手术；自主呼吸麻醉TheClinicalAnalysisofVideo-assistedThoracoscopicSurgeryin62CasesofMediastinalTumorbySpontaneousBreathingunderIntravenousAnesthesia/ZHANGXin，GUOZhi-hua，LIJing-pei，etal.//MedicalInnovationofChina，2017，14（22）：001-005【Abstract】Objective：Toinvestigatetheclinicalcurativeeffectofmediastinaltumorresectionunderthoracoscopeinthetreatmentofmediastinaltumorbyspontaneousbreathingunderintravenousanesthesia.Method：Theclinicaldataof124patientswithmediastinumtumorinourhospitalfromDecember2011toMarch2017wereretrospectiveanalyzedanddividedintotwogroupsaccordingtothedifferentoperationmethod，62casesineachgroup.Thecontrolgroupwasgiventraditionalvideo-assistedthoracicsurgery（VATS）mediastinaltumorresectionunderendotrachealtubeanesthesia，whiletheexperimentalgroupwasperformedVATSmediastinaltumorresectionbyspontaneousbreathingunderintravenousanesthesia.Thedifferenceofoperationtime，intra-operativebloodloss，postoperativeambulationtime，postoperativefeedingtime，pharyngodynia，irritablecough，lengthofhospitalstayandpostoperativecomplicationsbetweenthetwogroupswerecompared.Result：Twogroupsofpatientswereoperatedsuccessfully，withoutintraoperativeorpostoperativedeath.Thedifferenceswerenostatisticallysignificantintheoperationtime，intraoperativebloodloss，andlengthofhospitalstayoftwogroups（P＜0.05）.Thepostoperativeambulationtimeandpostoperativefeedingtime，pharyngodyniaandirritablecoughinexperimentalgroupwerebetterthanthoseofcontrolgroup（P＜0.05）.Conclusion：TheVATSmediastinaltumorresectionbyspontaneousbreathingunderintravenousanesthesiaarefeasibilityandsafetyinselectedpatiens.Ithasc