自主呼吸全凭静脉麻醉在间质性肺炎患者胸腔镜下肺活检术中的应用

Application of video assisted thoracic biopsy in interstitial pneumonia patients with spontaneous breathing during total intravenous general anesthesia

目的研究自主呼吸全凭静脉麻醉在间质性肺炎患者行胸腔镜下肺活检术中的应用的可行性与安全性。方法对60例行胸腔镜下肺活检手术的间质性肺炎患者采用保留自主呼吸全凭静脉麻醉,记录术中发生心律失常、躁动、咳嗽和中转气管内插管全麻的例数,分析开胸前、开胸后15 min及30min、关胸时、关胸后30 min的呼吸循环(HR、AP、SpO_2、RR、BIS)及动脉血气分析变化(pH、PaO_2、PaCO_2、BE、HCO_3^-)。结果患者在关胸时MAP、RR、BE、HCO_~3-与开胸前有统计学差异(P <0.05),而HR、SpO_2、pH、PaO_2、PaCO_2与开胸前无统计学差异。结论保留自主呼吸全凭静脉麻醉在间质性肺炎患者行胸腔镜下肺活检术是安全、可行的。

Objective To investigate the feasibility and safety of the application of video assisted thoracic biopsy in interstitial pneumonia patients with spontaneous breathing during total intravenous general anesthesia.Methods The video assisted thoracic biopsies of 60 cases with spontaneous breathing during total intravenous general anesthesia were recorded the occurrences of arrhythmia,restlessness,cough and transfer in the endotracheal intubation.Then,the changes of both the respiratory circulatory function(HR,MAP,SpO2,RR,BIS)and respiratory and cardiac factors analysis(pH,PaO2,PaCO2,BE,HCO3^-)in 15 min and 30 min following pre- and postthoracotomy,as well as 30 min during sternal closure and post-treatment.Results There were significant differences between sternal closure and pre-thoracotomy in the levels of MAP,RR,BE and HCO3^-,but not the HR,SpO2,pH,PaO2 and PaCO2 in the 60 cases.Conclusion The application of video assisted thoracic biopsy in interstitial pneumonia patients with spontaneous breathing during total intravenous general anesthesia is feasible and safe.