Chumpathong Saowapark, Tscheikuna Jamsak, Boonsombat Thanatporn, Muangman Saipin, Luansritisakul Choopong
*Department of Anesthesiology, Faculty of Medicine †Department of Medicine, Division of Respiratory Disease and Tuberculosis, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Bronchology Interv Pulmonol. 2017 Oct;24(4):268-274. doi: 10.1097/LBR.0000000000000387.
Interventional rigid bronchoscopy for tracheobronchial stenosis can be performed under total intravenous anesthesia and spontaneous-assisted ventilation. Intraoperative hypoxemia can occur during this procedure, but the incidence and risk factors have not yet been determined.
Medical records of patients who underwent rigid bronchoscopy for the treatment of tracheobronchial stenosis under total intravenous anesthesia and spontaneous-assisted ventilation during the study period from January 2011 to December 2012 were retrospectively reviewed.
There were 126 patients who underwent 263 procedures. The 2 main causes of tracheobronchial stenosis were tuberculosis (41.3%) and malignancy (35.7%). The 2 main locations of stenotic area were the trachea (58.6%) and the left main bronchus (46.4%). Tracheobronchial dilatation and stent insertion were performed in 78.7% and 21.3% of patients, respectively. The incidence of intraoperative hypoxemia was 25.5%. Independent risk factors for intraoperative hypoxemia were a degree of tracheal stenosis ≥75% (odds ratio: 2.48; 95% confidence interval, 1.19-5.17) and tumor removal procedure (odds ratio: 2.9; 95% confidence interval, 1.13-7.41).
Incidence of intraoperative hypoxemia during interventional rigid bronchoscopy for tracheobronchial stenosis under spontaneous-assisted ventilation was 25.5%. Risk factors for hypoxemia were a degree of tracheal stenosis ≥75% and tumor removal procedure.
气管支气管狭窄的介入性硬质支气管镜检查可在全静脉麻醉和自主辅助通气下进行。在此过程中可能会发生术中低氧血症,但发生率和危险因素尚未确定。
回顾性分析2011年1月至2012年12月研究期间在全静脉麻醉和自主辅助通气下接受硬质支气管镜检查治疗气管支气管狭窄患者的病历。
126例患者接受了263次手术。气管支气管狭窄的2个主要原因是结核病(41.3%)和恶性肿瘤(35.7%)。狭窄区域的2个主要部位是气管(58.6%)和左主支气管(46.4%)。分别有78.7%和21.3%的患者进行了气管支气管扩张和支架置入。术中低氧血症的发生率为25.5%。术中低氧血症的独立危险因素是气管狭窄程度≥75%(比值比:2.48;95%置信区间,1.19 - 5.17)和肿瘤切除手术(比值比:2.9;95%置信区间,1.13 - 7.41)。
在自主辅助通气下进行气管支气管狭窄的介入性硬质支气管镜检查时,术中低氧血症的发生率为25.5%。低氧血症的危险因素是气管狭窄程度≥75%和肿瘤切除手术。