非气管插管麻醉保留自主呼吸下单孔胸腔镜手术临床报道

Clinical report of uniportal thoracoscopic surgery under non-intubation anesthesia with spontaneous respiration

目的:分析非气管插管麻醉自主呼吸下单孔胸腔镜手术的短期疗效。方法:回顾性分析2018年8月~2019年6月行非气管插管麻醉保留自主呼吸下单孔胸腔镜手术14例的临床资料,其中原发性肺癌9例,肺炎性疾病3例,肺部结核肉芽肿1例,硬化性肺泡细胞瘤1例,合并肺大泡1例。结果:14例患者的结节直径平均为(1.81±0.97)cm,术后禁食时间和术后住院时间分别为(9.86±6.49)h和(4.21±1.53)d。结论:非气管插管麻醉保留自主呼吸下单孔胸腔镜在有选择的肺部结节患者中应用具有可行性和安全性,并能避免气管插管、高压机械通气及肌松药的应用。

Objective: To assess the short-term effect of uniportal thoracoscopic surgery using non-tracheal intubation anesthetic technique with spontaneous respiration. Methods :Retrospective analysis was performed in the clinical data of 14 cases received uniportal thoracoscopic surgery under tubeless anesthesia with spontaneous respiration between August 2018 and June 2019.Of the 14 cases,9 were primary lung cancer,3 pneumonia-related diseases,1 was pulmonary tuberculosis granuloma,1 sclerosing alveolar cell tumor and another 1 pulmonary bullae. Results :The average diameter of the nodules was (1.81±0.97)cm for the 14 patient.Duration of postoperative fasting and hospital stay was (9.86±6.49) h and (4.21±1.53) d,respectively. Conclusion :Uniportal thoracoscopic surgery under non-tracheal intubation anesthesia with spontaneous respiration is feasible and safe in patients undergoing selected removal of pulmonary nodules,particularly this technique can lead to blank use of endotracheal intubation,high-pressure mechanical ventilation and muscle relaxant.