胸腔镜下行肺癌手术的麻醉处理

Anesthesia of pneumonoresection with video-assisted thoracic surgery

目的总结胸腔镜下行肺癌手术的麻醉处理。方法所有患者均静脉快速诱导插入双腔支气管进行间歇正压通气(IPPV),单肺通气时采用IPPV加呼气末正压呼吸(PEEP)及萎陷肺持续正压通气(CPAP),并调整呼吸参数。结果所有患者双腔支气管插管经纤支镜调整定位良好,肺萎陷满意。动脉血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)维持正常范围。结论胸腔镜手术麻醉的关键是双腔管分隔完全,患侧肺萎陷满意。进行有效的单肺管理能使患者顺利度过围术期。

Objective To summarize the anesthesia of pneumonoresection in lung cancer patients with video - assisted thoracic surgery. Methods Doable - lumen tube bronchial catheter intubation and interstitial positive pressure ventilation （ IPPV ） were used in all patients with video - assisted thoracic surgery after fast - speed venous induced anesthesia. IPPV, PEEP and CPAP in collapse lobers of lung were used in one lung ventilation, and ventilation parameters were adjusted. Results Double - tubes bronchial catheter intubation used by fiberscope was located very well. The level of SpO2 ,PETCO2 could be maintained normal. Conclusion Anesthesia key of video - assisted thoracic surgery is that double lung must separated completely. Effective management of one lung ventilation could make patients to pass perioperation smoothly.