不同麻醉下电视胸腔镜肺手术患者的血流动力学监测

目的探讨不同麻醉下电视胸腔镜肺手术患者的血流动力学改变。方法将40 例择期行电视胸腔镜肺手术(VATS)的患者随机分为A组和B组,各20例。A组采用单纯静吸复合全麻,B组采用静吸复合全麻联合硬膜外阻滞麻醉。所有患者术中常规监测生命体征,观察并比较其入室时基础值(BASE)、插管后侧卧双肺通气15 min(DLV15)、单肺通气10 min(OLV10)、单肺通气20 min(OLV20)和单肺通气40 min(OLV40)各时间点HR、MAP、SaO2、PaO2 及PaCO2 变化。结果两组PaO2、SaO2 与基础值比较,差异有显著性意义(P<0.01,P<0.05),而各时间点参数差异不显著(均P>0.05)。结论两种麻醉方法均能安全有效地开展手术,而静吸复合全麻联合硬膜外阻滞麻醉较单纯静吸复合全麻具有麻醉药物用量小、患者苏醒快等优点。

Observation of Hemodynamics of patients during video-assisted Thoracoscopic Surgery with Different Anesthesia Methods

Objective To observe the changes in the hemodynamics of patients during video-assisted thoracoscopic surgery with different anesthesia methods.Methods Forty patients undergoing thoracoscopic surgery were randomly assigned into Group A (n=20) and Group B (n=20). The patients in the group A only received vein-inhalation mixed general anesthesia while the patients in the group B received vein-inhalation mixed general anesthesia plus epidural block anesthesia. During operation, the life signs of the patients were routinely monitored. The base values of HR, MAP, SaO 2, PaO 2, PaCO 2 and the values of these indicators 15 minutes after double lung ventilation, and 10, 20, 40 minutes after one-lung ventilation were observed and compared.Results Significant differences in PaO 2, SaO 2 were found between base values and values after the one or double lung ventilation in the two groups(P<0.01,P< 0.05 ). The parameters at different time points showed no significant differences(P>0.05,for all).Conclusion Operations were performed effectively under the two anesthesia methods. Received vein-inhalation mixed general anesthesia plus epidural block anesthesia was better than only received vein-inhalation mixed general anesthesia. Received vein-inhalation mixed general anesthesia.