建议在全身麻醉下进行食道内镜下粘膜剖析的病例特征
Atsushi Goto1, Koichi Hamabe2, Shunsuke Ito2
1Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, Yamaguchi, 755-8505, Japan. agoto@yamaguchi-u.ac.jp.
用于食道内镜下粘膜剖析 (ESD) 的全身麻醉提供了更稳定的程序和更快的剖析,特别是对于有癌史的患者. 这种方法减少了相比醇镇静剂的不良事件.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 麻醉学 麻醉学
背景情况:
- 食道内镜下粘膜解剖 (ESD) 是一种用于早期食道癌症的微创手术.
- 在复杂的ESD病例中,全身麻醉可能比镇静更有优势.
- 评估在全身麻醉下ESD的结果与propofol镇静相比是至关重要的.
研究的目的:
- 为了比较在全身麻醉下进行的食道ESD的临床特征和结果,与普罗波镇静相比.
- 确定可能受益于ESD全身麻醉的患者群体.
主要方法:
- 在265名患者 (2013-2023) 中对292例食道ESD手术进行了回顾性研究.
- 在全身麻醉下进行ESD的患者 (n=92) 和普罗波镇静 (n=200) 之间的结局比较.
- 分析影响剖析速度和不良事件的因素.
主要成果:
- 一般麻醉组的瘤直径更大,剖析速度更快 (39.8毫米对32.4毫米;10.5毫米2/分钟对7.5毫米2/分钟).
- 镇静组的低氧化,运动相关的中断和急性不良事件的发生率较高 (9.8%,13%,33.5%与0%,0%,21.7%).
- 喉癌病史与缓慢解剖和镇静组不良事件增加有关.
结论:
- 在全身麻醉下食道ESD是患者经历程序性不稳定性与propofol镇静的可行选择.
- 一般麻醉是特别推给患有喉癌病史的患者,因为增加了程序的困难和不良事件的风险.
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