Department of Cardiothoracic Surgery, Fujian Provincial Maternity and Children's Hospital, Fuzhou City, China.
Department of Cardiothoracic Surgery, Fujian Provincial Maternity and Children's Hospital, Fuzhou City, China.
J Cardiothorac Vasc Anesth. 2021 Aug;35(8):2326-2329. doi: 10.1053/j.jvca.2020.11.014. Epub 2020 Nov 10.
To compare the difference between single-lung ventilation with bronchial occlusion and double-lung ventilation with carbon dioxide artificial pneumothorax for thoracoscopic lobectomy in infants.
This was a retrospective study.
It was done in a teaching hospital.
Between March 2017 and April 2020, a total of 72 infants underwent thoracoscopic lobectomy in the authors' hospital.
Twenty-one patients received single-lung ventilation with bronchial occlusion, and 51 patients received carbon dioxide (CO) artificial pneumothorax.
The patient data included the endotracheal tube length, surgical exposure, intraoperative blood loss, and surgery duration. The mean arterial pressure (MAP), central venous pressure (CVP) and peak inspiratory pressure (Ppeak), partial pressure of oxygen in arterial blood (PaO), and partial pressure of carbon dioxide in arterial blood (PaCO) were measured at four points: time of bilateral lung ventilation before the thoracic surgery (T0), 10 minutes after the surgery started (T1), 30 minutes after the surgery started (T2), 60 minutes after the surgery started (T3), and 10 minutes after the surgery was over (T4).
Compared to artificial pneumothorax, the bronchial occlusion group has the following advantages: the surgical exposure was better, the surgery duration was shorter, there was less intraoperative bleeding, and the duration of tracheal intubation was shorter (p < 0.05); bronchial occlusion resulted in a lower MAP but a higher CVP in infants at T1, T2, and T3 (p < 0.05) than the artificial pneumothorax group and resulted in a lower PaCO and higher PaO at T2, T3, and T4 (p < 0.05). There was no significant difference in Ppeak between the two groups (p > 0.05).
Compared with CO artificial pneumothorax, bronchial occlusion is more favorable for thoracoscopic lobectomy in infants.
比较支气管封堵单肺通气与二氧化碳人工气胸双肺通气在婴儿胸腔镜肺叶切除术中的差异。
这是一项回顾性研究。
在一家教学医院进行。
2017 年 3 月至 2020 年 4 月，作者医院共有 72 例婴儿接受胸腔镜肺叶切除术。
21 例患者接受支气管封堵单肺通气，51 例患者接受二氧化碳（CO）人工气胸。
患者数据包括气管插管长度、手术暴露、术中出血量和手术时间。在四个时间点测量平均动脉压（MAP）、中心静脉压（CVP）和吸气峰压（Ppeak）、动脉血氧分压（PaO）和动脉血二氧化碳分压（PaCO）：胸腔手术前双肺通气时间（T0）、手术开始后 10 分钟（T1）、手术开始后 30 分钟（T2）、手术开始后 60 分钟（T3）和手术结束后 10 分钟（T4）。
与人工气胸相比，支气管封堵组具有以下优点：手术暴露更好，手术时间更短，术中出血量更少，气管插管时间更短（p<0.05）；支气管封堵在 T1、T2 和 T3 时使婴儿的 MAP 降低，但 CVP 升高（p<0.05），而在 T2、T3 和 T4 时使 PaCO 降低，PaO 升高（p<0.05）。两组间 Ppeak 无显著差异（p>0.05）。
与 CO 人工气胸相比，支气管封堵在婴儿胸腔镜肺叶切除术中更有利。
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