摘要
目的对两种不同方法Y型气管支架置入手术的麻醉管理,进行比较和总结,并评价其安全性及临床应用效果。方法68例拟行Y型气管支架置入术的重度恶性气管狭窄患者,根据气管支架置入方式的不同分为两组(纤支镜辅助组37例和DSA引导组31例)。纤支镜辅助组采用喉罩联合鼻咽通气道的方法,DSA引导组采用直接插入8.0#普通气管导管的方法,分别进行全身麻醉和气道管理。记录支架置入时间、苏醒时间、支架一次置入等情况,记录术中低氧血症、术后咽痛、声音嘶哑的发生情况。结果68例Y型气管支架手术均取得了成功,两组术后SPO_(2)均较术前明显升高(P<0.05),DSA引导组的支架置入时间明显短于纤支镜辅助组(P<0.01)。两组麻醉苏醒时间差异无意义(P>0.05),两组支架一次置入成功率、术中低氧血症发生率、术后咽痛和声音嘶哑发生率,差异无统计学意义(P>0.05)。结论纤支镜辅助下或DSA引导下放置Y型气管支架,均能取得较好的效果,麻醉医师需要根据支架置入方式的不同选择合适的麻醉和气道管理方案,才能保证手术的顺利进行和患者的安全。
Objective To compare the efficacy and security of the anesthetic management for insertion of Y shape tracheal stent by two implantation techniques,and to evaluate its safety and clinical application effect.Methods 68 cases of severe airway stenosis scheduled for Y shape stents implantation under general anesthesia were retrospectively analyzed.They were divided into two groups:the guidance with fiberoptic bronchoscope group(37 cases),and the guidance with DSA group(31 cases).Nasopharyngeal airway combined with laryngeal mask or 8.0#endotracheal tubes were used within management of general anesthesia for tracheal stents insertion respectively.The success rate of tracheal stent implantation at first attempt was recorded,the time of stent insertion and palinesthesia were also recorded.The development of intraoperative hypoxemia and postoperative pharyngeal complications were also recorded.Results The Y shaped airway stent was placed successfully in all cases.Compared with preoperative,the saturation of blood oxygen increased obviously after operation(P<0.05).The time of stent insertion in the bronchoscope group was shorter significantly than in the DSA group(P<0.01).There was no significant difference in the successful rate of the first attemptation to insertion between the two groups(P>0.05).Conclusion The insertion of the Y shape stent under guidance with fiberoptic bronchoscope or DSA is effective and safe.The most optimal scheme for management of anesthesia according to different implantation techniques is necessary for the safety of patients.
作者
胡友洋
吕丽萍
闵旭红
张欢欢
孟璐
HU You-yang;LU Li-ping;MIN Xu-hong;ZHANG Huan-huan;MENG Lu(Department of Anesthesiology,Anhui Chest Hospital,Hefei,Anhui 230023,China;Department of Interventional Pulmonary Disease,Anhui Chest Hospital,Hefei,Anhui 230023,China;Department of Interventional Radiology,Anhui Chest Hospital,Hefei,Anhui 230023,China)
出处
《临床肺科杂志》
2022年第6期866-869,共4页
Journal of Clinical Pulmonary Medicine
基金
安徽省卫生计生委科研计划项目(No.15tb005)。
关键词
气道狭窄
气管支架
鼻咽通气道
喉罩
airway stenosis
airway stents
nasopharyngeal airway
laryngeal mask
