摘要
目的:总结胸腔镜直视微创二尖瓣手术的麻醉经验,并评价经食道超声在术中的应用价值。方法:24例行胸腔镜直视微创二尖瓣手术的患者,以咪唑安定、依托咪酯、顺式阿曲库铵和舒芬太尼麻醉诱导,以丙泊酚与瑞芬太尼,间断给予舒芬太尼、咪唑安定、顺式阿曲库铵及吸入七氟醚作麻醉维持。术前以经食道超声评价病变特征、确定手术类型,术中指导上腔静脉引流管的放置,术后监测心脏排气,评价手术效果。结果:24例患者均成功完成手术,其中行二尖瓣置换术者17例,二尖瓣成形术7例。2例患者食道超声术中监测二尖瓣成形不满意,改为瓣膜置换术成功。未出现瓣周漏、血肿、空气栓塞等并发症。结论:对胸腔镜直视下微创二尖瓣手术患者,选择合适的麻醉方式,并全程进行经食道超声监测,能为手术成功提供充分保障、避免并发症。
Objective： To discuss the experience of anesthesia and the clinical practice ot transesopnageal ecnocardio-graphy （TEE） in thoracoscopy-assisted mitral valve surgery. Methods： 24 patients who underwent thoracoseopy-assis- ted mitral valve surgery were retrospectively analyzed. The induction of anesthesia was performed with midazolam, etomidate, cis-atracurium and sufentanil, and the anesthesia was maintained with propofol and remifentanil. TEE was used to determine the lesion characteristics, guide operation, monitor the air exhaust and evaluate the effect of opera- tion. Results： 17 patients underwent mitral valve replacement and 7 patients underwent mitral valvuloplasty successfully. 2 patients underwent mitral valve replacement due to dissatisfied repair effect based on TEE evaluation. No complications were found in all patients. Conclusion： Appropriate anesthesia programs contributed to the process of operation and TEE guidance provided detailed information during operation, which guaranteed the success of operation in the thoracoscopy-assisted mitral valve surgery with less complications.
出处
《医学理论与实践》
2015年第21期2891-2892,共2页
The Journal of Medical Theory and Practice
关键词
胸腔镜
二尖瓣手术
麻醉
Thoracoscopy, Mitral valve surgery, Anesthesia
