非气管插管麻醉保留自主呼吸胸腔镜手术治疗早期非小细胞肺癌的疗效分析

【摘要】 目的 探讨非气管插管麻醉下保留自主呼吸胸腔镜手术治疗早期非小细胞肺癌的安全性、可行性和技术要点。方法 回顾性分析2018年6月至2020年6月于湖州市中心医院非气管插管麻醉下保留自主呼吸进行胸腔镜手术的患者74例，最终纳入48例作为观察组。另选取同期行气管插管麻醉手术的患者56例作为对照组。比较两组手术患者的麻醉时间、手术时间、术中出血量、术后24小时引流量、术后住院时间、术后并发症发生率以及淋巴结清扫数目。结果 两组行肺叶切除、肺段切除的手术时间比较，差异均无统计学意义（P>0.05）。两组行肺叶切除、楔形切除、肺段切除的术中出血量比较，差异均无统计学意义（P>0.05）。两组的麻醉时间、术后24小时引流量、术后并发症发生率、淋巴结清扫数比较，差异均无统计学意义（P>0.05）。观察组的术后住院时间、楔形切除手术时间与对照组比较，差异均有统计学意义（P<0.05）。结论 非气管插管麻醉下保留自主呼吸胸腔镜手术治疗早期非小细胞肺癌的手术创伤小、术后恢复快、住院时间短，在术者、患者及麻醉条件适合的前提下安全可行。更多还原

【Abstract】 Objective To investigate the safety,feasibility and technical key points of thoracoscopic surgery with spontaneous respiration under non-tracheal intubation anesthesia in the treatment of early non-small cell lung cancer. Methods A retrospective analysis was performed on 74 patients undergoing thoracoscopic surgery with spontaneous breathing under non-tracheal intubation anesthesia in Huzhou Central Hospital from June 2018 to June 2020,and 48 patients were included as the observation group. Another 56 patients who underwent endotracheal intubation anesthesia during the same period were selected as the control group. The anesthesia time,operation time,intraoperative blood loss,24 hours postoperative drainage,postoperative hospital stay,postoperative complication rate and numbers of lymph node dissection were compared between the two groups. Results There was no significant difference in the operative time of lobectomy and segmental resection between the two groups(P>0.05). There was no significant difference in intraoperative blood loss between the two groups after lobectomy,wedge resection and segmentectomy(P>0.05). There were no significant differences in anesthesia time,24 hours postoperative drainage,postoperative complication rate and lymph node dissection numbers between the two groups(P>0.05). There were statistically significant differences between the observation group and the control group in the length of postoperative hospital stay and the length of wedge resection(P<0.05). Conclusion Thoracoscopic surgery with self-preservation of breathing under non-tracheal intubation anesthesia for the treatment of early non-small cell lung cancer has less surgical trauma, faster postoperative recovery, and shorter hospitalization time. It is safe and feasible under the premise of suitable surgeons, patient and anesthesia conditions.更多还原