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气管切除与重建治疗上气管狭窄:气管插管与非气管插管

Resection and Reconstruction of the Trachea for the Treatment of Upper Tracheal Stenosis: Tracheal Versus Non-Tracheal Intubation.

作者信息

Li Feng, Liang Jing, Li Xiaogang

机构信息

Department of Anesthesiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.

Department of Radiotherapy, Shaanxi Provincial Tumor Hospital, Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.

出版信息

J Coll Physicians Surg Pak. 2018 Nov;28(11):879-881. doi: 10.29271/jcpsp.2018.11.879.

Abstract

Tracheal stenosis may occur secondary to trauma, tumors, infections, and inflammatory and iatrogenic diseases. Patients with tracheal stenosis must be evaluated carefully and require comprehensive preoperative examination, including pulmonary function tests and radiographic studies. Two male patients (one 18 years of age and the other 46 years of age) with tracheal stenosis were scheduled for tracheal resection and reconstruction. They were given different modes of anesthesia (with and without intubation). Fiberoptic intubation was selected in the 18-year patient, and non-intubation was selected in 46-year patient. Invasive blood pressure monitoring was established prior to the induction of anesthesia. Both operations were successful without any untoward events. However, the choice of intubation resulted in prolonged stay and increased overall expenses. Therefore, it is suggested that non-tracheal intubation anesthesia should be used for resection of stenosis due to rapid postoperative recovery, shorten hospital stay, and lower cost. However, sufficient sedation and analgesia should be given and careful attention should be paid to patients.

摘要

气管狭窄可能继发于创伤、肿瘤、感染以及炎症和医源性疾病。气管狭窄患者必须接受仔细评估,需要进行全面的术前检查,包括肺功能测试和影像学检查。两名患有气管狭窄的男性患者(一名18岁,另一名46岁)计划接受气管切除和重建手术。他们接受了不同的麻醉方式(插管和非插管)。18岁患者选择了纤维支气管镜插管,46岁患者选择了非插管。在麻醉诱导前建立有创血压监测。两台手术均成功,无任何不良事件。然而,插管的选择导致住院时间延长和总费用增加。因此,建议对于狭窄切除术应采用非气管插管麻醉,因其术后恢复快、缩短住院时间且费用较低。然而,应给予充分的镇静和镇痛,并密切关注患者。

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