【摘要】 目的评估喉罩全麻小潮气量高频双肺通气胸腔镜手术治疗肺大疱的可行性和安全性。方法试验组与对照组各30例肺大疱患者。试验组在喉罩小潮气量高频双肺通气全麻下行胸腔镜手术;对照组在双腔气管插管全麻单肺通气下进行胸腔镜手术。结果喉罩组与插管组在麻醉和手术时间、最低氧饱和度、最高呼末二氧化碳分压、术野和麻醉满意度、失血量无明显差异。喉罩组手术前后白细胞、中性粒细胞百分比升高程度明显低于插管组,术后清醒时间、开始进食时间、下地时间、术后住院时间和引流时间均比插管组短;喉罩组胃肠道反应、咽部不适、声嘶发生率也低于对照组。结论喉罩全麻胸腔镜手术治疗肺大疱具有良好的可操作性和安全性。更多还原

【Abstract】 Objective To assess the feasibility and safety of thoracoscopic bulla resection under laryngeal mask anesthesia with low tidal volume high-frequency lung ventilation.Methods Sixty patients with pulmonary bulla were randomized into two groups（n=30） to undergo video-assisted thoracoscopic surgery（VATS） for bulla resection with laryngeal mask anesthesia and high-frequency low tidal volume lung ventilation general anesthesia and or with intubation anesthesia and one-lung ventilation through double-lumen endotracheal intubation.Results No significant differences were found in anesthesia time, surgery time,intraoperative lowest SpO₂,intraoperative highest PerCO₂,operative field,anesthetic effects,or blood loss between the two groups.The post-operative WBC and NEU%showed significantly smaller increments in the mask anesthesia group than in the intubation group,and the postoperative awake time,initial eating time,ambulation time,in-hospital stay, and drainage time were significantly shortened in the former group with also lower incidences of gastrointestinal reactions, throat discomfort and hoarseness.Conclusion Thoracoscopic bulla resection under laryngeal mask anesthesia with low tidal volume high-frequency lung ventilation is safe and feasible and results in better patient satisfaction and shorter in-hospital stay than procedures performed under intubation anesthesia with one-lung ventilation.更多还原