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胸腔镜手术中支气管阻断器与二氧化碳人工气胸在婴儿中的应用比较。

Extraluminal Placement of a Bronchial Blocker Compared with Carbon Dioxide Artificial Pneumothorax in Infants Undergoing Video-Assisted Thoracoscopic Surgery.

机构信息

Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.

Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China.

出版信息

Ann Thorac Cardiovasc Surg. 2022 Feb 20;28(1):48-55. doi: 10.5761/atcs.oa.21-00050. Epub 2021 Jul 23.

Abstract

OBJECTIVE

To investigate the safety and effectiveness of extraluminal placement of a bronchial blocker compared with carbon dioxide (CO) artificial pneumothorax in infants undergoing video-assisted thoracoscopic surgery (VATS).

METHODS

The study involved 33 infants (group A) who underwent one-lung ventilation (OLV) with extraluminal placement of a bronchial blocker and 35 other infants (group B) who underwent CO artificial pneumothorax. Clinical characteristics, the degree of lung collapse, and complications were compared.

RESULTS

The degree of lung collapse in group A was significantly higher than that in group B at T2 and T3. The mean arterial pressure (MAP) of group B was significantly lower than that of group A at 10 min and 30 min after OLV. The partial pressure of carbon dioxide (PaCO) of group B was significantly higher than that of group A at 30 min after OLV. The incidence of hypotension in group B was higher than that in group A.

CONCLUSION

Compared with CO artificial pneumothorax, extraluminal placement of a bronchial blocker is associated with a better degree of lung collapse, fewer episodes of hypotension, and lower PaCO accumulation during OLV in infants undergoing VATS.

摘要

目的

研究支气管阻塞器体外放置与二氧化碳(CO)人工气胸在婴儿行电视辅助胸腔镜手术(VATS)中应用的安全性和有效性。

方法

本研究纳入了 33 例行支气管阻塞器体外放置单肺通气(OLV)的婴儿(A 组)和 35 例行 CO 人工气胸的婴儿(B 组)。比较两组的临床特征、肺萎陷程度和并发症。

结果

A 组在 T2 和 T3 时肺萎陷程度明显高于 B 组。OLV 后 10 min 和 30 min,B 组的平均动脉压(MAP)明显低于 A 组。OLV 后 30 min,B 组的二氧化碳分压(PaCO)明显高于 A 组。B 组低血压的发生率高于 A 组。

结论

与 CO 人工气胸相比,在 VATS 中,婴儿行 OLV 时,支气管阻塞器体外放置与更好的肺萎陷程度、更少的低血压发作和更低的 PaCO 积累相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6078/8915942/b38ee355b52d/atcs-28-048-g001.jpg

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