新生儿胸腔镜手术麻醉进展

Anesthesia advances in neonatal thoracoscopic surgery

新生儿胸腔镜微创外科发展为现代麻醉学带来了前所未有的挑战。新生儿特殊的生理学特点、疾病病理学改变及手术方式、麻醉药物、术中通气方式等诸多因素影响着新生儿胸腔镜微创手术围术期的安全性及治疗疗效。该文从人工气胸期间可能出现的低氧血症、通气障碍、高碳酸血症、低温、低血压等一系列并发症人手分析原因，探讨解决方案，对如何提高新生儿微创外科麻醉安全性进行阐述。

The development of thoracoscopic minimal invasive neonate surgery has brought unprece- dented challenges for modem anesthesiology. Many factors including neonatal physiology, pathological changes and surgery itself, anesthetic techniques and intraoperative ventilation mode affect neonate perioperative safety and therapeutic efficacy. We analyze the reasons and solutions of complications by focusing on the perioperative hypoxemia,hypercapnia, ventilatory disorders and hypotension that may occur during artificial pneumothorax to improve the anesthetic safety of neonate minimal invasive surgery.