喉罩全麻胸腔镜下纵隔肿瘤切除的临床应用

Clinical application of thoracoscope mediastinal tumor resection with laryngeal mask anesthesia

摘要:

目的   探讨喉罩全麻胸腔镜下纵隔肿瘤切除的临床应用价值。方法  将2012年-2015年该科收治的纵隔肿瘤患者40例，随机分为两组，每组20例，喉罩组行喉罩通气静脉麻醉下胸腔镜纵隔肿瘤切除术，插管组行双腔插管麻醉胸腔镜下纵隔肿瘤切除术，对比两者整体效果。结果  两组患者均顺利完成胸腔镜下手术，无中转开胸病例，喉罩组术前麻醉时间短，麻醉及手术过程中血压及脉搏波动小，术后复苏躁动少、时间短，术后咽部不适及咽痛发生率低，较插管组差异有统计学意义（P <0.05）；手术时间，术野暴露满意度，术中出血量，术后拔管时间及住院天数等指标差异无统计学意义（P >0.05）。结论  喉罩通气静脉麻醉在胸腔镜纵隔肿瘤切除术中实用性好，在术前麻醉时间、对心血管系统影响、术后复苏及术后咽痛等方面优于插管组，可在临床加以推广应用。

Abstract:

Objective To evaluate the clinical application of thoracoscope mediastinal tumor resection with the laryngeal mask anesthesia. Methods 40 cases of mediastinal tumors were randomly divided into two groups from 2012 to 2015, 20 cases in each group. Laryngeal mask group performed thoracoscope mediastinal tumor resection with laryngeal mask anesthesia and the Intubation group performed thoracoscope mediastinal tumor resection double-lume nendo tracheal intubation anesthesia, then compare the overall effect. Results All the patients were successfully completed with the thoracoscope surgery, no transfer to open chest cases. The preoperative anesthesia time of laryngeal mask group was shorter, blood pressure and pulse range of wave was smaller in the process of anesthesia and surgery, move restlessly was less, postoperative recovery time was shorter, and lower incidence of postoperative pharynx ministry unwell and sore throat, so the laryngeal mask group shows statistically significance comparing with the intubation group (P < 0.05); Operative time, operative field exposure satisfaction, intraoperative blood loss, postoperative extubation time and hospitalization days have no statistical significance (P > 0.05). Conclusion The laryngeal mask airway intravenous anesthesia in thoracoscope mediastinal tumor resection in practical good, in the preoperative anesthesia and postoperative recovery time and postoperative sore throat was better than that of intubation group, so should be extended in clinical treatment.