两种麻醉方式在胸腔镜辅助小切口治疗自发性气胸中的比较

Comparison of Two Anesthesia Methods in Video-assisted Thoracoscopic Treatment for Spontaneous Pneumothorax

目的探讨两种麻醉方式在胸腔镜辅助小切口治疗自发性气胸的效果。方法选取胸腔镜辅助小切口治疗自发性气胸34例，随机分为2组：Ⅰ组为单纯气管插管全麻；Ⅱ组采用气管插管全麻和连硬外麻醉。结果所有患者双腔支气管插管调整定位良好，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。结论胸腔镜辅助小切口手术麻醉使用双腔支气管插管全麻联合使用硬膜外麻醉，具有双肺分隔完全，患侧肺萎陷满意，术后疼痛轻，躁动小，结合有效的通气管理能使患者顺利渡过围术期。

Objective To compare the efficacy of two anesthesia methods in Video-assisted thoracoscopic treatment of spontaneous pneumothorax. Methods 34 patients were randomly divided into two groups with17 patients in each. Group Ⅱ： Combined anesthesia and groupⅠ： General anesthesia. In group Ⅱ, continuous epidural anesthesia was used first and then double-lumen endobronchial after rapid induction of intravenous. When being contralateral single-lung ventilation, IPPV combined with PEEP were used, and adjusting respiratory parameters as well. In groupⅠ, double-lumen endobronchial anesthesia was used. Results The position of the double-lumen endobronchial was true and the collapse of lungs was well. SPO2 and PetCO2 were in the normal range during the operation. Conclusion Double-lumen endotracheal intubation anesthesia combined with continuous epidural anesthesia in video-assisted thoracoscopic surgery can separate the lungs completely, with satisfactory collapse of the lung and light pain after the operation. And patients could go well through the perioperative period with effective ventilating management during the surgery.