纤维气管镜直视下Y型金属覆膜气管支架置入术的麻醉管理

Anesthesia Management of Y-shaped Metal Covered Tracheal Stent Implantation Under Fiber Bronchoscope

目的探讨全身麻醉纤维气管镜直视下Y型金属覆膜气管支架置入术的安全性和可行性。方法回顾性分析2020年1月~8月我院纤维气管镜直视下Y型金属覆膜气管支架置入病例4例,分析麻醉管理中的相关注意问题。结果4例患者均成功置入Y型金属覆膜气管支架,手术时间25~80 min,麻醉时间45~97 min,支架置入时间2.5~4.5 min;所有患者在检查过程中生命体征平稳,BP、HR波动于基础值±20%以内;无一例出现明显心律失常、呛咳、出血、支架移位;SpO_(2)在支架置入后较基础值明显改善,PETCO_(2)术中出现一过性升高,支架置入后下降明显,术毕12~20 min拔出喉罩,术后呼吸困难立即改善;术后第一天复查纤维气管镜未发现并发症。结论全身麻醉纤维气管镜直视下行Y型金属覆膜气管支架置入术安全有效,能快速解除气道梗阻。

Objective To explore the safety and feasibility of Y-shaped metal covered tracheal stent placement under general anesthesia fiber bronchoscope.Methods A retrospective analysis of 4 cases of Y-shaped metal covered tracheal stent implantation under fiber bronchoscopy in our hospital from January to August 2020 was retrospectively analyzed,and related attention issues in anesthesia management were analyzed.Results All 4 patients were successfully implanted with Y-type metal covered tracheal stent.The operation time was 25-80 min,the anesthesia time was 45-97 min,and the stent placement time was 2.5-4.5 min.During the examination,the vital signs of all patients were stable,and BP and HR fluctuated within±20%of the baseline value;no case had obvious arrhythmia,coughing,bleeding,or stent displacement;SpO_(2) was significantly improved compared with the basic value after stent placement.During PETCO_(2),there was a transient increase and a significant decrease after stent placement.After the operation,the laryngeal mask was removed 12 to 20 min,and the postoperative dyspnea was immediately improved;No complications were found in the fiber bronchoscopy on the first day after surgery.Conclusion The Y-type metal covered tracheal stent implantation under general anesthesia fiber bronchoscope is safe and effective,and can quickly relieve airway obstruction.