喉罩麻醉与气管插管麻醉在单孔胸腔镜双侧胸交感神经T3/T4切断术的比较分析

目的　对比分析喉罩麻醉与气管插管麻醉在单孔胸腔镜双侧胸交感神经T3/T4切断术中的临床应用效果。方法　采用病例对照研究方法，回顾性分析2017年1月至2021年10月揭阳市人民医院胸心外科行微创手术治疗的80例重度手汗症患者的临床资料，按照麻醉的方式划分为喉罩麻醉（Ⅰ组，40例）和气管插管麻醉（Ⅱ组，40例）2组。Ⅰ组男21例、女19例，年龄（20.8±4.6）岁；Ⅱ组男17例、女23例，年龄（20.9±4.7）岁。比较两组患者的住院总天数、术后的住院天数、麻醉费用、住院费用、视野暴露评分、麻醉效果评分、手术时间以及麻醉时间、术后并发症发生率等指标。符合正态分布的计量资料采用独立样本t检验；不符合正态分布的计量资料或等级资料采用秩和检验；计数资料采用卡方检验或Fisher确切概率法。结果　Ⅰ组的住院总天数为2.0（2.0，2.0）d、术后住院天数为1.0（1.0，1.0）d、麻醉费用为（2 442.9±420.2）元、住院总费用为（10 848.2±1 238.4）元、麻醉时间为（75.1±18.0）min，Ⅱ组的住院总天数为3.0（3.0，4.0）d、术后住院天数为2.0（2.0，3.0）d、麻醉费用为（2 883.7±242.3）元、住院总费用为（12 739.5±917.1）元、麻醉时间为（97.9±23.1）min，Ⅰ组上述指标均优于Ⅱ组，在咽喉疼痛的发生率方面，Ⅰ组明显低于Ⅱ组，差异均有统计学意义（均P<0.05）。两组视野暴露评分、麻醉效果评分、手术时间以及其他术后并发症发生率比较，差异均无统计学意义（均P>0.05）。结论　单孔胸腔镜双侧胸交感神经T3/T4切断术接受喉罩麻醉安全性高、麻醉效果好，适用于手汗症微创术后加速康复外科模式。

Comparative analysis of laryngeal mask anesthesia and endotracheal intubation anesthesia in single-hole thoracoscopic bilateral thoracic sympathectomy T3/T4

Objective　To compare and analyze the clinical effects of laryngeal mask anesthesia and endotracheal intubation anesthesia in single-hole thoracoscopic bilateral thoracic sympathectomy T3/T4. Methods　It was a case control study. The clinical data of 80 patients with severe palmar hyperhidrosis who underwent minimally invasive surgery in the department of cardiothoracic surgery of Jieyang People's Hospital from January 2017 to October 2021 were retrospectively analyzed. They were divided into two groups, undergoing laryngeal mask anesthesia (group Ⅰ, 40 cases) and endotracheal intubation anesthesia (group Ⅱ, 40 cases) respectively. There were 21 males and 19 females in group Ⅰ, aged (20.8±4.6) years; there were 17 males and 23 females in group Ⅱ, aged (20.9±4.7) years. The total hospital stay, postoperative hospital stay, anesthesia cost, hospitalization cost, visual field exposure score, anesthetic effect score, operation time, anesthesia time, incidence of postoperative complications, and other indicators were compared. Independent sample t test was used for the measurement data conforming to normal distribution, rank sum test was used for the measurement data conforming to abnormal distribution or the grade data, and Chi-square test or Fisher's exact probability method was used for the count data. Results　The total length of stay in group Ⅰ was 2.0 (2.0, 2.0) d, the postoperative length of stay was 1.0 (1.0, 1.0) d, the anesthesia cost was (2 442.9±420.2) Yuan, the total hospitalization cost was (10 848.2±1 238.4) Yuan, and the anesthesia time was (75.1±18.0) min, the total length of stay in group Ⅱ was 3.0 (3.0, 4.0) d, the postoperative length of stay was 2.0 (2.0, 3.0) d, the anesthesia cost was (2 883.7±242.3) Yuan, the total hospitalization cost was (12 739.5±917.1) Yuan, and the anesthesia time was (97.9±23.1) min, the above indexes in group Ⅰ were better than those in group Ⅱ, and the incidence of throat pain in group Ⅰ was significantly lower than that in group Ⅱ, with statistically significant differences (all P<0.05). There were no statistically significant differences in the visual field exposure score, anesthetic effect score, operation time, and incidences of other postoperative complications between the two groups (all P>0.05). Conclusions　Laryngeal mask anesthesia is safe and effective in single-hole thoracoscopic bilateral thoracic sympathectomy T3/T4. It is suitable for accelerated rehabilitation surgery after minimally invasive surgery for palmar hyperhidrosis.