【摘要】 目的 探讨胸腔镜体外循环心脏手术中实施超快通道麻醉的临床经验。方法 回顾性分析2019年3月至2020年12月广东省人民医院珠海医院开展心脏手术的患者的临床资料。结果 2019年3月至2020年12月广东省人民医院珠海医院共开展心脏手术90例，包括胸腔镜心脏手术56例，其中32例实施超快通道麻醉即手术结束后即刻拔管。超快通道麻醉手术类型包括二尖瓣置换术11例，同期三尖瓣成形术7例；房间隔缺损修补术3例，合并二尖瓣置换术1例；室间隔缺损修补术2例；二尖瓣成形术12例，同期行三尖瓣成形术9例；三尖瓣成形术1例；左心房黏液瘤切除术3例。其中患者的心肺流转时间、麻醉时间、手术时间分别为（158.2±41）min、（63.3±79.2）min、（280.7±79.4）min，患者术后住院时间为（10.1±6.5）d,1例患者因胸腔出血再次气管插管行胸腔镜下止血术。所有患者术后均无严重并发症发生，均顺利出院。结论 在胸腔镜体外循环心脏手术中实施超快通道麻醉，麻醉效果良好，安全度高。更多还原

【Abstract】 Objectives To explore the clinical experience of ultra-fast-track anesthesia in thoracoscopic cardiac surgery with cardiopulmonary bypass.Methods The clinical data of patients who underwent ultra-fast-track anesthesia during thoracoscopic cardiac surgery from March 2019 to December 2020 in Guangdong Provincial People′s Hospital Zhuhai Golden Bay Hospital were reviewed retrospectively.Results Guangdong Provincial People′s Hospital Zhuhai Golden Bay Hospital from March 2019 to December 2020,of which 56cases were performed thoracoscopic cardiac surgery,among which 32 cases underwent ultra-fast-track anesthesia. The double-lumen endotracheal tubes were successfully removed after surgery in the operation room. Surgical types of ultrafast channel anesthesia included mitral valve replacement in 11 cases and tricuspid valvuloplasty in 7 cases;Atrial septal defect repair in 3 cases and mitral valve replacement in 1 case;Ventricular septal defect repair in 2 cases;Mitral valvuloplasty in 12 cases and tricuspid valvuloplasty in 9 cases;Tricuspid valvuloplasty in 1 case;Resection of left atrial myxoma in 3 cases. Among them,the duration of cardiopulmonary bypass duration,anesthesia duration and operation duration of the patients were respectively:(158.2±41)min,(363.3±79.2)min,(280.7±79.4)min. The postoperative hospitalization duration of the patients was(10.1±6.5)d. One patient received thoracoscopic hemostasis after re-endotracheal intubation due to the thoracichemorrhage. No serious complications occurred in all the patients after surgery,and all the patients were discharged successfully.Conclusions surgery has good anesthesia effect,quick recovery and short hospitalization duration.更多还原