胸腔镜下肺癌手术时单肺通气的临床麻醉分析

目的 探讨胸腔镜下行肺癌手术时单肺通气的临床麻醉情况.方法 分析218例胸腔镜下行肺癌手术患者,均采用静脉快速诱导插入双腔支气管导管,运用纤维支气管镜进行定位后进行间歇性正压通气（IPPV）,而单肺通气则采用IPPV或加呼气末正压呼吸和萎缩肺持续正压通气,对呼吸参数进行调整.结果 MAP、HR和SaO2在麻醉前、双肺IPPV和单肺的IPPV30 min、IPPV60 min、IPPV 90 min、IPPV 120 min和双肺IPPV15 min比较无明显差异性（P〉0.05）,而PaCO2和PETCO2则有明显的差异性（P〈0.05）;其中双肺IPPV和单肺IPPV在FiO2和TV方面比较也有差异性（P〈0.05）.结论 单肺通气可使胸腔镜下治疗肺癌手术时患侧肺萎缩满意,可顺利度过手术期.

Clinical anesthesia analysis of single-lung ventilation during lung cancer surgery under thoracoscope

Objective To investigate the clinical anesthesia for single-lung ventilation during lung cancer surgery under thoraco- scope. Methods 218 patients, who received lung cancer surgery under thoracoscope, were given IPPV through rapid intravenous induc- tion into double-lumen endobronchial tube positioned by bronchoseopy. Single-lung ventilation was adopted IPPV or end-expiration pres- sure breath and continuous positive pressure ventilation of shrinking lung. Results There was no significant difference on MAP, HR and SaO2 before anesthesia, 30 minutes, 60 minute, and 120 minutes after IPPV （P 〉 0. 05 ） , but the levels of PaCO2 and PETCO2 showed significant difference （ P 〈 O. 05 ）. Conclusion Single-lung ventilation can keep patients, who receive lung cancer surgery under thoraco- scope, undergo the surgery successfully, with satisfying atrophy of ipsilateral lung.