32例胸腔镜手术单肺通气时患者呼吸管理及麻醉处理

目的:探讨胸腔镜手术单肺通气时患者呼吸的管理及麻醉处理。方法:回顾性总结32例电视胸腔镜手术患者的临床资料,麻醉诱导时采用双腔气管插管,术中行单肺通气。结果:32例中有3例在单肺通气1 h后SpO2明显下降,通过调整呼吸参数,改吸入纯氧等措施,SpO2逐渐回升至正常;另1例经以上方法处理无效,改行手法人工控制呼吸,交替施行单肺及双肺通气后低氧情况得到改善。全部患者手术过程顺利,无麻醉并发症。结论:正确应用双腔支气管插管通气,术中加强呼吸管理、可改善单肺通气时的低氧血症,为胸腔镜手术创造良好的条件。

Influence of one-lung ventilation on respirotorg management for patieats undergoing video-assisted thoracoscopic surgery and related anesthesia strategies

Objective:To discuss the influence factors of one-lung ventilation on respiratorg management for patients undergoing video-assisted thoracoscopic surgery and related anesthesia management intraoperativelg.Methods:Reviewing clinical data of patients who have received video-assisted thoracoscopic surgery ventilated by double-lumen tube intubation.Results: Among 32 cases,3 patients showed SpO2 decrease siguificautlg at 1 hour following one-lung ventilation.By adjusting respiratory parameters and oxygen inhalation,SpO2 can be improved and the value achieved above 96%.Dne case failed to response to above management.the condition was improved after manual style of control ventilation and alternation of one-lung ventilation to two-lung ventilations alternately.All patients were finished successfully and without complications.Conclusion: Corrective use of double-lumen tube intubation,adequate preparation before surgery,strengthened managemant during operation,and careful treatment of intraoperative hypoxemia can provide a favorable condition for video-assisted thoracoscopic surgery.