喉罩全麻胸腔镜治疗原发自发性气胸的临床应用

Clinical application of laryngeal mask anesthesia in video-assisted thoracoscopic surgery for primary spontaneous pneumothorax

目的评价喉罩全麻在胸腔镜手术治疗原发自发性气胸中的可行性与安全性。方法选取40例行胸腔镜手术治疗原发自发性气胸患者的临床资料。其中20例采用喉罩全麻(喉罩组),20例采用双腔气管插管全麻(气管插管组)。比较、分析两组术中、术后相关指标。结果所有患者均顺利完成手术,无中转开胸和死亡病例。两组术中指标:手术时间、术中出血量、术中最低SpO2、术中最高PetCO2比较差异无统计学意义(P>0.05);术后指标:术后胃肠道反应、术后咽喉疼痛、术后声嘶、术后引流时间、术后住院时间比较差异有统计学意义(P<0.05),麻醉苏醒时间、术后进食时间、术后下地时间比较有显著差异(P<0.001);麻醉费用及住院总费用两组间有显著差异(P<0.001),手术费用两组差异无统计学意义(P>0.05)。结论喉罩全麻胸腔镜治疗原发自发性气胸安全可行,麻醉时间短,气道损伤小,术后恢复快,值得临床推广。

Objective To assess the feasibility and safety of laryngeal mask anesthesia in treatment of primary spontaneous pneumothorax by video-assisted thoracoscopic surgery.Methods The clinical data of 40 patients with primary spontaneous pneumothorax treated by thoracoscopy were selected,including 20 cases of laryngeal mask anesthesia(the laryngeal mask group)and 20 cases of double-lumen intubation anesthesia(the intubation anesthesia group).The intraoperative and postoperative indicators were compared between the two groups.Results The operations were completed successfully in both groups,and there was no conversation to thoracotomy or death.There was no significant difference in intraoperative indicators such as operation time,introperative bleed loss,introperative minimum SpO 2,introperative highest PetCO 2 between the two groups(P>0.05).There were statistical differences in the incidence of postoperative gastrointestinal reaction,postoperative hoarseness,postoperative throat pain,drainage dowelling time and duration of postoperative hospital stay between the two groups(P<0.05).There were significant differences in the postoperative awake time,initial eating time after surgery and postoperative ambulation time(P<0.001).There was significant difference in the cost of narcotic drugs and hospitalization(P<0.001),but no significant difference in surgery cost between the two groups(P>0.05).Conclusion Laryngeal mask anesthesia in treatment of primary spontaneous pneumothorax by video-assisted thoracoscopic surgery is safe and feasible,and it has many advantages such as short anesthesia time,small airway damage,and rapid postoperative recovery,which should be generalized.