心脏手术微创时代麻醉学带教的难点与对策

Difficulties and countermeasures of anesthetic training in the era of minimally invasive heart surgery

微创心脏手术目前在我国蓬勃开展。由于麻醉医师不能像常规正中开胸直视下心脏手术一样直视判断血容量及心肌收缩与舒张功能,并且需要单肺通气,在带教实习医师、住院医师与进修医师学习微创心脏手术麻醉时会产生一些带教难点:如何判断血容量是否合适,如何判断心功能是否正常,如何纠正单肺通气时低氧血症等,文章对此进行了分析与解答。

Minimally invasive heart surgery develops vigorously in our country.Problems emerge when anesthetists cannot see and evaluate the blood volume and the heart systolic and diastolic function as directly as in conventional median sternotomy in heart surgery.This paper discusses difficulties of teaching anesthesia in minimally invasive heart surgery to interns,resident doctors and traninee doctors and provides solutions as to how to perform a good anesthesia,evaluate blood volume,judge heart function and correct hypoxemia during one lung ventilation.