摘要
目的探讨原发性气管癌肿瘤切除术围麻醉期管理方法。方法术前经纤维支气管镜检、CT扫描、X线片等确诊:患者气管右后壁有一大小约2.5cm×2.5cm×1.5cm肿瘤,距声门、隆突分别为6.5cm和5.0cm,约占气管管腔的2/3。经积极术前准备,静脉快速诱导肿瘤上气管内插管,开胸后左支气管插管的静吸复合全麻,麻醉维持采用异氟醚、肌松药,应用各种有创监测及严密的呼吸道管理,并根据其病理生理变化及时处理异常情况。结果围麻醉期并发症处理及时,手术顺利,患者痊愈出院。结论术前的正确评估,麻醉插管方法的正确选用,术中、术后加强监护等围麻醉期处理有重要临床意义。
Objective To probe the experience in anesthesia management of the surgical t reatment of primary tracheal carcinoma.Methods Pre-operative branchofiberosc ope,CT,and chest X-rays confirmed primary tracheal carcinoma,as about 2.5 cm×2.5cm×1.5cm size,generated in the right and posterior ward of inner lumen of trachea,6.5cm far from glottis and5.0cm from carina,occupied t wo thirds of the inner diameter.Anesthesia was induced with propofol-fentanyl -vecuronium and was maintained with isoflurane,combined with vecuronium intrav enously.Tracheal intubation upon the carcinoma was performed at first,and lef t bronchial intubation was finished after opening thorax.With various kinds of invasive monitoring and intensive airway management,special ventilation,and al so according to patho -physiological changes,most abnormality can be treated. Results Anesthesia management met some difficulty in understanding of the anat omical and physiological consequences,but the patient was cured under intensi ve care timely managing complication after operation and is alive and well21da ys after surgery.Conclusion Careful preoperative evaluation,proper anesthesia intubation,and intensive monitoring(in operation,and postoperatively)are es sential to the successful surgical treatment of primary tracheal carcinoma.[
出处
《实用医药杂志》
2003年第2期90-92,共3页
Practical Journal of Medicine & Pharmacy
