气管、支气管重建术的麻醉和呼吸管理

目的探讨气管、支气管重建术的麻醉和呼吸管理,保证气管离断时足够的通气和氧气供应。方法对98例气管和支气管肿瘤患者施行了肺叶切除兼气管或支气管重建术,术中采用静脉麻醉及套管法和换管法进行通气和氧供。结果所有手术麻醉均取得了良好的效果,对术前痰量少和咳血不多的患者采用套管法,其能容纳光镜检查和抽吸分泌物;对咳血多、分泌物多的患者采用换管法,可防止血痰倒流,较为可靠安全。结论采用套管法和换管法均能充分保证气管离断时足够的通气和氧气供应,方法简便,具有很好的临床价值。

Anaesthesia and Respiratory Control of Tracheal and Bronchial Reconstruction

Objective To study the Anaesthesia method and respiratory control in tracheal and branehial reconstructive operation in order to ensure the enough ventilation and oxygen supply during tracheal mutilation. Methods 98 patients with tracheobronchial tumor underwent lobectomy and tracheal or branehial reconstructive operation, Total intravenous anesthesia was used during the operation, double-pipe and tube replacement technique were used for ventilation and oxygenation. Results Successful management of anesthesia was ob rained during the operation, double-pipe technique was used for the patients with few sputum and emptysis while tube replacement technique were used for the patients with more emptysis and secretion, which is more salty by preventing bloody sputum reflux. Conclusion Double-pipe and tube replacement technique can all guarantee enough ventilation and oxygenation when the tracheal was broken. This technique is handy and valuable for clinic.