喉罩通气全麻下经支气管镜高频电刀治疗中央型肺癌12例的临床观察

Clinical Observation on High-frequency Electrocautery via Bronchoscopy in Treatment of Central Lung Carcinoma Under Laryngeal Mask General Anesthesia

目的:探讨喉罩通气全麻下经支气管镜应用高频电刀治疗晚期中央型肺癌导致的气道阻塞的疗效。方法:选择晚期中央型肺癌阻塞大气道导致呼吸困难的患者12例,在用异丙酚、芬太尼和维库溴铵行静脉全身麻醉后,再在喉罩通气下经支气管镜应用高频电刀对病变进行治疗。结果:12例患者经支气管镜下高频电力治疗后呼吸困难得到明显改善,气道直径由(3.20±1.56)mm扩大到(7.02±1.23)mm,差异有统计学意义(P<0.01);气促评分治疗前为(2.90±0.66)级,治疗后为(1.05±0.32)级,差异有统计学意义(P<0.01)。结论:全麻下经喉罩通气高频电刀治疗中央型肺癌导致的气道阻塞,可以迅速缓解患者呼吸困难症状,改善生活质量,同时术中借助喉罩通气扩大了气管镜下介入治疗的适应证,手术安全、可行,为临床治疗重度气道梗阻提供了一种新的治疗手段。

Objective：To investigate the therapeutic effects of high-frequency electrocautery via bronchoscopy in treatment of central lung carcinoma under laryngeal mask general anesthesia.Methods：Twelve patients with advanced central lung carcinoma with dyspnea were treated by high-frequency electrocautery via bronchoscopy after use of propofol,fentanyl and vecuronium intravenous general anesthesia.Results：Dyspnea was improved obviously after the treatment of high-frequency electrocautery via bronchoscopy in all 12 patients.The airway diameter of these patients was（3.20±1.56） mm expanded to（7.02±1.23） mm（P0.01）,short of breath index was（2.90±0.66） before treatment and（1.05±0.32） after treatment,there were significant differences between them（P0.01）.Conclusions：High-frequency electrocautery via bronchoscopy under laryngeal mask general anesthesia can relieve dyspnea rapidly and improve the quality of life in patients with central lung carcinoma associated with tracheobronchial obstruction.Meanwhile,it expanded the indication of interventions by laryngeal mask.It is safe and feasible,and provides a new treatment for severe airway obstruction.