摘要
目的总结气管内肿瘤切除与气道重建术的麻醉经验。方法对1999年1月至2005年12月20例行气管内肿瘤切除与气道重建手术的麻醉处理进行分析。根据肿瘤部位(上、中、下段)、大小和气管阻塞程度决定麻醉和气道处理。结果全组无一例麻醉意外。术中有2例小儿未行气管插管,3例(15.0%)出现SpO2<90%,经多次吸痰、鼓肺后,SpO2回升至95%以上。术毕3例通气良好,SpO295%,清醒后拔除气管导管,2例带“T”形管,其余12例留置气管导管返胸外监护室,于24 h内拔除气管导管;1例患者术毕自主呼吸SpO2<90%,留置气管导管入ICU,呼吸机辅助呼吸,16 h后脱机,48 h后拔除气管导管。结论气管内肿瘤切除术麻醉方法的选择,应根据肿瘤部位、大小、气管阻塞程度以及与邻近组织的关系而定,镇痛健忘慢诱导是比较安全的诱导方式。术中麻醉处理的关键在于既要维持良好的通气功能,又要保证手术的顺利进行。
Objective To summarize the experience in anesthetic management during resection of intratracheal tumor. Methods A retrospective analysis of the anaesthetic management was conducted in 20 cases of intratracbeal tumor treated in our hospital from 1999 to 2005. The anesthetic methods were determined according to the location of tumor, the degree of tracheal obstraction and the surgical procedures. Results No severe complications occured related to anesthesia procedures. Two cases of child were without intubation. During the operation the saturation of pulse oxygen（ SpO2 ）transiently decreased to below 90% in 5 cases（ 15.0% ）but recovered to normal level by aspiration of airway secretions and/or lung inflation. Three patients were extubated after the operation and returned to the ward safely,two cases were with T type tube, while another 12 cases were sent to thoracic intensive care unit and extubated wihin 24 h. SpO2 in one patient was below 90% with spontaneous breath and was sent to surgical intensive care unit with assistant of respirator for 16 hours and extubated after 48 h. Conclusion Case-specific anesthetic plan is necessary before the operation, analgesia induction is a safer means of induction, and it is crucial to maintain good ventilation without interfering with the surgical procedures during the operation.
出处
《中国肿瘤临床与康复》
2006年第3期219-221,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
基金
国家自然科学基金(No.30300327)资助项目
关键词
气管肿瘤
麻醉
镇痛健忘慢诱导
Tracheal neoplasms
Anesthesia
Analgesia induction
