上消化道内镜黏膜下剥离术的全麻管理

Management of general anesthesia in endoscopic submucosal dissection of upper digestive tract

目的探讨上消化道内镜黏膜下剥离术(ESD)的全麻管理方法及其相关并发症的麻醉处理。方法对1 79例在消化内镜中心行上消化道ESD手术患者的临床数据进行登记、整理,分析ESD全麻管理方法及其相关并发症的麻醉处理方法。结果麻醉相关不良事件:困难气道3例,反流误吸2例,严重心律失常2例。手术相关并发症:ESD相关穿孔发生率为5.03%,ESD术中出血的发生率约60.34%,术后延迟出血的发生率约为3.35%。结论符合ESD自身特点的术前评估及麻醉管理,有利于预防和及时处理ESD手术麻醉相关并发症,为ESD提供有效安全保障。

Objective To review the management of general anesthesia under tracheal intubation in endoscopic submu- cosal dissection （ESD） of upper digestive tract. Methods The clinical data of 179 patients undergoing ESD of upper digestive tract from January 2014 to December 2014 were retrospectively analyzed. Results Among 179 patients the difficult airway oc- curred in 3 cases, aspiration in 2 cases and severe arrhythmia in 2 cases. The incidence of ESD perforation was 5.03%, and the incidence of intraoperative bleeding and delayed bleeding were 60.34% and 3.35%, respectively. Conclusion The preoperative assessment and appropriate management of general anesthesia can effectively prevent anesthesia-related complications in en- doscopic submucosal dissection.