摘要
目的探讨胸腔镜手术并发严重复张性肺水肿的发病机理与防治。 方法胸腔镜手术 40 0例 ,年龄 18～ 81岁 ,ASAⅡ～Ⅲ ,手术包括肺大泡切除术 ,纵隔、肺肿瘤切除或活检术 ,应用双腔支气管麻醉 ,术中单肺通气。结果发生严重复张性肺水肿 5例 ,3例在术中 30～ 45min时发生 ,2例在术毕发生 ,经及时诊治均抢救成功 ,痊愈出院。 结论充分认识复张肺水肿的发病机理。认真做好预防措施 ,术中、术后严密观察 ,及时诊治 ,复张性肺水肿的发生率可以降低。
Objective To discuss the machanism, prevention, and treatment of concurrent with severe reexpansion pulmonary edema in thoracoscopic operations. Methods Four hundred (age 18 ～81years, ASA Ⅱ ～ Ⅲ), underwent thoracoscopic operations, which included pulmonary bubble resections, mediastinum or lung tumor biopsie or resections. All patients were anesthetized with one-lung ventilation using a double-lumen endobronchial tube. Results Five patients were complicated with severe reexpansion pulmonary edema which happened 30 ～45min during operation in 3 patients and immediately after the cesation of the operation in 2 cases. Conclusion Recognition of the mechanism, adoption of preventive methods and careful observation during and after operation, together with early diagnosis and treatment may decrease the incidence of reexpansion pulmonary edema.
出处
《上海第二医科大学学报》
CSCD
2002年第4期361-363,共3页
Acta Universitatis Medicinalis Secondae Shanghai
关键词
胸腔镜
复张性肺水肿
单肺通气
thoracoscopy
reexpansion pulmonary edema
one lung ventilation
