免气管插管和双腔气管插管胸腔镜肺大疱切除术的对比研究

Thoracoscopic Bullectomy by Nonintubated or Intubated Anesthesia: a Comparative Analysis of Clinical Effects

目的对比免气管插管和传统双腔气管插管胸腔镜肺大疱切除术的安全性和可行性。方法 2016年6月～2018年5月,行免气管插管胸腔镜肺大疱切除术50例(免管组),同期行全麻双腔气管插管胸腔镜肺大疱切除术50例(插管组),2组术前临床资料差异无统计学意义,比较2组麻醉和手术指标。结果 2组均顺利完成手术,与插管组比较,免管组术前麻醉准备时间短[(17. 6±3. 0) min vs.(41. 5±5. 4) min,t=27. 130,P=0. 000],术后苏醒时间短[(22. 0±4. 0) min vs.(40. 6±6. 0) min,t=18. 330,P=0. 000],胸管引流时间短[(22. 3±5. 5) h vs.(24. 6±4. 3) h,t=2. 328,P=0. 022],术后住院时间短[(2. 2±0. 7) d vs.(2. 8±0. 4) d,t=4. 681,P=0. 000],麻醉费用少[(1896. 0±310. 5)元vs.(3734. 0±359. 3)元,t=27. 370,P=0. 000]。结论免气管插管的胸腔镜肺大疱切除术具有安全、便捷的优点,可以减少麻醉副作用,缩短住院时间,降低医疗费用,符合快速康复理念。

Objective To explore the safety and clinical efficacy of nonintubated thoraeoseopie bulleetomy. Methods We retrospectively analyzed clinical data of 50 patients who underwent nonintubated thoraeoseopie bulleetomy in our hospital from June 2016 to May 2018. Meanwhile 50 patients underwent thoraeoseopie bulleetomy with tranditional intubated anesthesia as control group. There was no statistical difference in preoperative clinical data of the patients between the two groups. Surgical and anesthetic indexes of two groups were compared. Results All the operations were successfully completed. Compared with the control group, patients in the nonintubated group had shorter duration of anesthesia induction time [（17.6±3.0） rain vs. （41.5±5.4） rain, t = 27. 130, P = 0.0001, shorter awake time [（22.0±4.0） rain vs. （40.6±6.0） rain, t=18.330, P=0.0001 , shorter duration of chest drainage [（22.3±5.5） h vs. （24.6±4.3） h, t=2.328, P=0.0221 , shorter postoperative hospital stay[（2.2±0.7） d vs. （2.8±0.4） d, t=4.681, P =0.0001, and less anesthesia costs [（1896.0±310.5） RMB vs. （3734.0±359.3） RMB, t =27.370, P = 0. 0001- Conclusion Nonintubated thoraeoseopie bulleetomy is technically feasible and safe with reduced complications, less medical cost and shorter hospital stay, which fits the idea of fast recovery.