胸内气管肿瘤切除术麻醉处理

目的：探讨胸内气管肿瘤切除术的麻醉处理方法。方法：回顾性分析中山大学肿瘤防治中心2003年～2008年收治的6例及国内期刊发表的33篇共205例胸内气管肿瘤切除术麻醉处理方法。结果：本中心6例患者麻醉期并发症处理及时，手术成功。所查205例手术中，辅用部分体外循环技术23例，辅用喷射通气50例。未用肌松剂气管插管61例，用肌松剂后插管78例。插管置于肿瘤上方82例，置于肿瘤下方20例。麻醉期发生严重并发症10例，发生率为4．88％，麻醉死亡3例，死亡率为1．46％。结论：胸内气管肿瘤切除术麻醉处理复杂，风险极大，周密的麻醉计划，熟知各种麻醉方法，与术者良好的沟通，有利于提高麻醉的安全性。

Anesthetic Management for Intrathoracic Tracheal Tumor Resection

Objective：To investigate the anesthetic management for intrathoracic tracheal tumor resection. Methods： Retrospective analysis of anesthetic management was conducted in 6 cases undergoing intrathoracic tracheal tumor resection in Cancer Center, Sun Yat-Sen University during 2003-2008, and other 205 cases in domestic periodicals. Results： The anesthetic complications of the 6 cases in the center were treated timely, and the operations were successful. Among the 205 cases, there were 23 cases applying cardiopulmonary bypass, 50 cases applying jet ventilation. 61 cases were tracheal intubated without applying muscle relaxants, while 78 cases were intubated after applying muscle relaxants. Endotracheal tubes of 82 cases were inserted above the tumor and those of 20 cases were below the tumor. There were 10 cases of severe anesthetic complications, and the rate was 4.48%. There were 3 cases of anesthetic death, and the mortality was 1.46%. Conclusion： The anesthetic management for intrathoracic tracheal tumor resection is complicated and highly risked. Meticulous anesthesia planning, knowledge of various anesthetic techniques, and good communication between anesthetists and surgeons can improve the anesthetic safety.