胸腔镜治疗新生儿先天性食管闭锁的麻醉体会

目的总结新生儿先天性食管闭锁(EA)胸腔镜手术治疗的麻醉特点。方法北京军区总医院麻醉科对35例先天性食管闭锁(EA)患儿行胸腔镜矫治手术,均采用气管插管静吸复合全麻,并全程监测血压、心率、脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PETCO2)、体温等指标。结果术中患儿无一例死亡。麻醉后所有患儿均出现一过性心率减慢,28例出现短暂的SpO2下降和PETCO2升高。结论术前积极改善全身状况能提高患儿对手术和麻醉的耐受性。选择气管内插管静吸复合全麻,加强监测,确保呼吸、循环平稳,可提高麻醉的满意度。

Anesthetic Management during Thoracoscopy in the Treatment of Congenital Esophageal Atresia

Objective To summarize the anesthesia features in thoracoscopic operation for treatment of neonatal congenital esophageal atresia.Methods 35 patients with congenital esophageal atresia in Beijing Military General Hospital of PLA were given orthodontic operation,using intravenous general anesthesia of tracheal intubation,and heart rate,SpO2,PETCO2,body temperature and other parameters were monitored during the whole course.Results No deaths happened during the operation.After anesthesia all patients were developed transient reduction of heart rate,transient decrease of SpO2 and increase of PETCO2 appeared in 28 cases.Conclusion Preoperative active improvement of systemic condition can improve children tolerance for operation and anesthesia.Selection of combined intravenous anesthesia endotracheal intubation,strengthened monitoring,ensuring the steady breath and circulation can improve the satisfaction of anesthesia.