干旱区生态环境知识资源中心(Arid): 气管切除术麻醉及手术方式探讨

Arid

	气管切除术麻醉及手术方式探讨
其他题名	Anesthesia and operative approach of resection of the trachea
	赵凤瑞; 张银合; 杨金龙; 邢学忠; 云阔
来源期刊	中华外科杂志
ISSN	0529-5815
出版年	2005
卷号	43 期号:2 页码:83-86
中文摘要	目的探讨不同气管疾病气管切除的麻醉和手术方式.方法回顾性分析18例气管切除手术的临床资料,分析麻醉和手术方法的选择及其与结果的关系.结果局部麻醉(局麻)气管切开插管麻醉2例,经气管造口插管麻醉2例,体外循环2例,气管插管全身麻醉12例,全组无麻醉和手术死亡.局部切除3例,节段性切除15例,气管切除最长8.0 cm.节段性切除后一期吻合8例,记忆合金网二期成形人工气管7例,人工气管长度3.0～5.0 cm.随访5个月～8年,4例因肿瘤等原因分别死于术后4,11及12个月,其余均生存.结论气管切除的麻醉与手术方式因人而异,高危患者可以体外循环,或者局麻下气管切开插管;开胸后切开气管或右主支气管,行左主支气管插管是有效、安全的麻醉方法.全身状况差者可仅行局部切除,切除气管小于5 cm者可行节段性切除一期吻合,大于5.5 cm者,可以用记忆合金网二期成形人工气管重建气管缺损.
英文摘要	Objective Review and discuss anesthesia and operative approach of resection of the trachea for different tracheal diseases, especially for the resection of long-segment of trachea. At the same time to introduce the method of reconstruction of long-segment of trachea with Zhao’s (two-stage procedure with memory-alloy mesh) artificial trachea. Methods Retrospective study of 18 cases of tracheal resection, analysis of the relation between the choice of anesthetic and operative approach. Results General anesthesia through cut open the trachea with local anesthesia in 2 oases, general anesthesia through previous tracheotomy in 2 cases, extracorporeal circulation in 2 cases, general anesthesia through endotracheal tube in 12 cases. There were no anesthetic or operaLive death. Local resection in 3 cases, segmental resection in 15 cases. The longest segmenlal resection was 8. 0 cm. Primary anastomosis after segmental resection in 8 cases, Reconstruction with Zhao’s artificial trachea in 7 cases. Postoperative follow-up was 5 months to 8 years. Four cases died from systemic metastasis or other reasons at 4,11 and 12 months, respectively. Conclusions Different methods of anesthetic and operative procedures should be used for different patients. Extracorporeal circulation used for patient with highest dangerous condition, or, for which could be inserted endotracheal lube by tracheotomy with local anesthesia. Conservative local resection performed only for patients with very bad general condition. Segmental resection less than 5 cm long could be reconstructed with primary reanastomosis. Resection longer than 5. 5 cm could be reconstructed with Zhao’s artificial trachea.
中文关键词	胸外科手术 ; 气管切开术 ; 麻醉 ; 气管 ; 人工器官
英文关键词	Thoracic surgical procedures Tracheotomy Anesthesia Trachea Artificial organs
语种	中文
国家	中国
收录类别	CSCD
WOS类目	SURGERY
WOS研究方向	Surgery
CSCD记录号	CSCD:1928857
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/207085
作者单位	北京市健宫医院胸外科, 北京 100054, 中国
推荐引用方式 GB/T 7714	赵凤瑞,张银合,杨金龙,等. 气管切除术麻醉及手术方式探讨[J],2005,43(2):83-86.
APA	赵凤瑞,张银合,杨金龙,邢学忠,&云阔.(2005).气管切除术麻醉及手术方式探讨.中华外科杂志,43(2),83-86.
MLA	赵凤瑞,et al."气管切除术麻醉及手术方式探讨".中华外科杂志 43.2(2005):83-86.