CAJ | 학술논문

目的：探讨保留自主呼吸的喉罩全身麻醉在胸腔镜肺大疱切除手术的应用的安全性与可行性。方法：喉罩组与气管插管组各20例肺大疱患者。两组患者均采用全凭静脉麻醉诱导与维持，喉罩组不使用肌松药，插入喉罩术中保留自主呼吸，气管插管组使用肌松药，插入双腔支气管导管。结果：喉罩组与气管插管组的手术视野满意度与术后1h 血气分析结果无差异（P＞0.05），喉罩组的麻醉复苏时间[（11.7±3.7）min vs（30.2±9.8）min，P﹤0.05]、住院时间[（4.9±1.4）d vs（7.7±1.8）d，P﹤0.05]较气管插管组短，住院费用[（27243.5±3312.4）元 vs（36721.0±4421.7）元，P﹤0.05]更低。结论：保留自主呼吸的喉罩全身麻醉在胸腔镜肺大疱切除手术中的应用是安全可靠的。
목적：탐토보류자주호흡적후조전신마취재흉강경폐대포절제수술적응용적안전성여가행성。방법：후조조여기관삽관조각20례폐대포환자。량조환자균채용전빙정맥마취유도여유지，후조조불사용기송약，삽입후조술중보류자주호흡，기관삽관조사용기송약，삽입쌍강지기관도관。결과：후조조여기관삽관조적수술시야만의도여술후1h 혈기분석결과무차이（P＞0.05），후조조적마취복소시간[（11.7±3.7）min vs（30.2±9.8）min，P﹤0.05]、주원시간[（4.9±1.4）d vs（7.7±1.8）d，P﹤0.05]교기관삽관조단，주원비용[（27243.5±3312.4）원 vs（36721.0±4421.7）원，P﹤0.05]경저。결론：보류자주호흡적후조전신마취재흉강경폐대포절제수술중적응용시안전가고적。
Objective:To investigate the safety and feasibility of laryngeal mask airway( LMA)with spontaneous breathing under general anesthesia in thoracoscopic resection of pulmonary bullae. Methods:All patients with pulmonary bullae were divided into LMA group and tracheal intubation group(n = 20 each). Both groups were induced and maintained by total intravenous anesthesia. Muscle relaxants were administered in endotracheal intubation group but not in LMA group. LMA group and tracheal intubation group underwent LMA intubation with spontaneous breathing and double-lumen endobronchial intubation,respectively. Results:No significant differences were found in surgical field satisfaction and 1h postoperative blood gas analysis between LMA group and tracheal intubation group(P>0.05). The time for recovery of anaesthesia and hospital stay in LMA group was significantly shorter than those in tracheal intubation group[(11.7±3.7)min vs.(30.2±9.8) min,(4.9±1.4)d vs.(7.7±1.8)d,P﹤0.05],and the hospitalization cast was significantly lower[(27243.5± 3312.4)yuan vs.(36721.0±4421.7)yuan,P﹤0.05]. Conclusion:The application of LMA with spontaneous breathing under general anesthesia in thoracoscopic resection of pulmonary bullae is safe and reliable.