55例小儿前纵隔肿瘤手术的麻醉经验总结

Anesthetic management of 55 children with anterior mediastinal tumors

目的·总结小儿前纵隔肿瘤手术的临床麻醉经验。方法·回顾性分析55例前纵隔肿瘤患儿的麻醉管理资料。患儿根据纵隔肿瘤全身麻醉风险分级表分为安全组(n=22)、不确定组(n=19)及不安全组(n=14),并根据不同的分级予以不同的麻醉策略。记录3组患儿的一般资料、标准化肿瘤体积(standardized tumor volume,STV)、麻醉期间与肿瘤相关的不良事件及术后拔管时间。结果·安全组、不确定组及不安全组的一般资料比较,差异无统计学意义(P>0.05),3组间STV及术后拔管时间的差异有统计学意义(P<0.05),3组患儿麻醉维持阶段均发生与肿瘤相关的不良事件,及时处理后均安全完成手术麻醉。结论·结合纵隔肿瘤患儿全身麻醉风险分级,有利于麻醉的管理;麻醉过程中需严密监测生命体征,及时发现和处理不良事件,避免灾难性事件的发生。

Objective·To summarize the anesthetic management of surgical treatment for children with anterior mediastinal tumors.Methods·The anesthetic management data of 55 children with anterior mediastinal tumors were retrospectively analyzed.Children with mediastinal tumors were divided into safe group(n=22),uncertain group(n=19)and unsafe group(n=14)according to the general anesthesia risk classification table,and different anesthesia strategies were given according to different grades.General data,standardized tumor volume(STV),adverse events related to tumors and extubation time were recorded.Results·The general data of safe group,uncertain group and unsafe group had no statistical difference(P>0.05).There were significant differences in STV and extubation time after operation among the three groups(P<0.05).Adverse events related to tumors occurred in the maintenance stage of anesthesia in three groups,and the operation was completed safely after timely treatment.Conclusion·It is conducive to the management of anesthesia combined with the risk classification of general anesthesia in children with mediastinal tumors.The vital signs should be closely monitored during anesthesia,and adverse events should be detected and handled in time to avoid catastrophic events.