单孔胸腔镜下保留自主呼吸喉罩麻醉在肺大泡切除术中的应用

Application of anesthesia with laryngeal mask airway with spontaneous breathing under single-hole thoracoscopy in bullae resection

目的观察单孔胸腔镜下保留自主呼吸喉罩麻醉在肺大泡切除术中的应用效果。方法选择2018年5月至2020年5月在福建省龙岩市第二医院行单孔胸腔镜肺大泡切除术治疗的患者98例,根据随机数字表分为对照组(n=49)和研究组(n=49)。对照组采用双腔支气管导管插管全麻,研究组采用保留自主呼吸喉罩麻醉。比较两组术后恢复指标、治疗费用,插管前后HR、MAP变化情况及术后并发症发生率。结果与对照组相比,研究组术后苏醒时间、住院时间、下床活动时间短,住院总费用少,差异有统计学意义(P<0.001);两组插管后HR、MAP均较插管前降低,研究组HR、MAP高于对照组,差异有统计学意义(P<0.01);研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论单孔胸腔镜肺大泡切除术采用保留自主呼吸喉罩麻醉可降低并发症发生率,缩短患者术后恢复时间,减少治疗费用。

Objective To observe the effect of anesthesia with laryngeal mask airway with spontaneous breathing under single-hole thoracoscopy in bullae resection.Methods From May 2018 to May 2020,98 patients with single-hole thoracoscopic bulla resection in our hospital were selected and divided into control group(n=49)and study group(n=49)by random number table.The control group were anesthetized with double-lumen endobronchial tube,and the study group were anesthetized with laryngeal mask airway with spontaneous breathing.And then,postoperative recovery indexes,treatment costs,changes in HR and MAP before and after intubation,and the incidence of postoperative complications were compared between the two groups.Results Compared with the control group,the study group had shorter postoperative awakening time,hospitalization time and time of out-of-bed activity,and less total hospitalization cost,and the difference was statistically significant(P<0.001).After intubation,HR and MAP in both groups were lower than those before intubation,while those in the study group were higher than those in the control group,and the difference was statistically significant(P<0.01).The incidence of complications in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Anesthesia with laryngeal mask airway with spontaneous breathing in bullae resection can reduce the incidence of complications,shorten postoperative recovery time and reduce treatment cost.