全身麻醉下气管支架植入术治疗恶性气管狭窄的临床分析

Clinical Analysis of Tracheal Stent Implantation Under General Anesthesia for Malignant Tracheal Stenosis

目的阐述恶性气管狭窄患者接受气管支架植入术治疗过程中麻醉具体措施,并对麻醉方案进行分析。方法研究对象便利抽选2017年1月—2019年12月期间于该院诊断罹患恶性气管狭窄需接受气管支架植入术治疗的患者60例,随其进行随机分组,对照组采取全身麻醉方案,观察组采取无痛下局麻联合全身麻醉方案,监测两组患者手术过程中心率、血压等生理指标变化情况,评测比对各组患者麻醉后气道质量,统计各组患者全麻药物使用剂量及清醒时间,分析差异性。结果两组患者麻醉前及清醒后,心率、血压等生理指标大致相近,差异无统计学意义(P>0.05),术中均有一定程度降低,观察组患者心率指标(79.23±6.75)次/min、舒张压指标(79.34±4.02)mmHg、收缩压指标(116.58±6.06)mm Hg均相较对照组较高,差异有统计学意义(t=5.191、7.582、4.362,P<0.05)。麻醉后,观察组患者气道质量相较对照组更优,差异有统计学意义(P<0.05)。同时,观察组患者全麻药物使用剂量(100.58±14.05)mL相较对照组更少,且患者清醒时间(4.76±1.15)min明显短于对照组,差异有统计学意义(t=11.480、18.074,P<0.05)。结论恶性气管狭窄患者在接受气管支架植入术治疗前采取无痛局麻联合全麻的方式效果更佳,能够有效提高麻醉后患者气道质量,缩减全麻药物用量,安全性更高,更适用于老年人群。

Objective The specific measures of anesthesia in patients with malignant tracheal stenosis undergoing tracheal stent implantation were described,and the anesthesia plan was analyzed.Methods The study subjects conveniently selected 60 patients who were diagnosed with malignant tracheal stenosis in the hospital from January 2017 to December 2019 and required tracheal stent implantation.They were randomly divided into groups.The control group received general anesthesia and the observation group A plan of painless local anesthesia combined with general anesthesia was adopted to monitor the changes in physiological indicators such as central rate and blood pressure during the operation of the two groups of patients,evaluate and compare the airway quality of each group after anesthesia,and count the doses of general anesthesia drugs used and wakefulness in each group Time,analyze the differences.Results Before anesthesia and after being awake,the heart rate,blood pressure and other physiological indicators of the two groups were roughly similar,the difference was not statistically significant(P>0.05),and they were all reduced to a certain extent during the operation.The heart rate indicators of the observation group were(79.23±6.75)beats/min and the diastolic blood pressure indicators(79.34±4.02)mmHg and systolic blood pressure index(116.58±6.06)mmHg were higher than those of the control group(t=5.191,7.582,4.362,P<0.05).After anesthesia,the airway quality of the observation group was better than that of the control group,the difference was statistically significant(P<0.05).At the same time,the dose of general anesthetics used in the observation group was(100.58±14.05)mL less than that in the control group,and the patient's awake time(4.76±1.15)min was significantly shorter than that of the control group,the difference was statistically significant(t=11.480,18.074,P<0.05).Conclusion The combination of painless local anesthesia and general anesthesia is more effective in patients with malignant tracheal stenosis before tracheal stent implantation.It can effectively improve the quality of airway after anesthesia,reduce the dosage of general anesthesia drugs,and has higher safety.It is more suitable for the elderly and middle-aged people,and it is worth popularizing.