非输管视频辅助胸腔镜外科手术
Gao Bin1, Luo Wenjun2, Gui Yu3
1Department of Anesthesia, Second Affiliated Hospital of Zhejiang University School of Medicine; Department of Anesthesia, The First Affiliated Hospital of Ningbo University.
Journal of visualized experiments : JoVE
|June 12, 2023
概括
使用保存自主呼吸的非输入胸部手术为全身麻醉提供了更安全的替代方案,减少肺部并发症并改善患者的康复. 这种方法最大限度地降低了与气管管道输入和通风相关的风险.
科学领域:
- 胸部外科手术 胸部外科手术
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
背景情况:
- 在全身麻醉下进行双光线输管是胸部手术的标准,如肺切除术,叶片切除术和切除术.
- 气管输管的全身麻醉与肺部并发症的高发病率有关,包括呼吸道创伤和通风引起的肺损伤.
- 保持自愿呼吸的非输入麻醉提供了减轻这些不良影响的替代方案.
研究的目的:
- 介绍一个非输入管视频辅助胸腔镜手术 (VATS) 的简要方案,以保持自主呼吸.
- 在VATS期间确定从非输入到输入麻醉的转换条件.
- 讨论胸部手术中非输管麻醉的优点和局限性.
主要方法:
- 为VATS开发和应用一个非输入式协议.
- 这是一项追溯性研究,涉及58名接受非直管VATS的患者.
- 非输入管的VATS与传统的输入管全身麻醉之间的结果比较.
主要成果:
- 与直管组相比,非直管的VATS组患者的术后肺部并发症发生率较低.
- 非输管的VATS与更短的手术时间,减少手术期间的血液损失和更短的麻醉后护理单位 (PACU) 停留有关.
- 非输入式方法导致胸部排水去除的日数减少,术后排水减少,整体住院时间缩短.
结论:
- 在特定的胸部手术中,带有自主呼吸的非输入式VATS是输入式全身麻醉的可行和有利的替代方案.
- 这种技术显著减少了肺部并发症,并改善了康复指标,包括手术时间,血液损失和住院时间.
- 提出的协议和转换标准有助于在胸部外科手术中安全实施非输入式麻醉.
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