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双肺和单肺通气在双侧胸腔镜下扩大胸腺切除术治疗重症肌无力中的比较:回顾性研究
贵州医科大学 麻醉与心脏电生理课题组 翻译：安丽 编辑：潘志军 审校：曹莹 背景 重症肌无力（MG）是一种自身免疫性疾病，建议早期切除胸腺。自从电视胸腔镜手术引入以来，胸腔内二氧化碳注入（capnothorax）的安全性和有效性一直存在争议。本研究旨在比较双肺和单肺通气在双侧电视胸腔镜下扩大胸腺切除术（BVET）中的安全性和有效性。 方法 我们回顾性调查了2016年8月至2018年1月期间接受BVET治疗的MG患者的医疗记录。患者分为两组：D组（n=26）单肺通气组和S组（n=28）双肺通气组。我们设定九个麻醉时间点（T0–T8），并收集了呼吸和血流动力学变量，包括动脉氧合指数（PaO2/FiO2）。 结果 D组在T1–T3和T8时的SpO2显著低于S组。S组在所有时间点的FiO2均低于D组。PaO2/FiO2的数量≤ 300和PaO2/FiO2≤200 的发生率显著高于S组。两组在任何时间点的血液动力学变量均无显著差异。S组的手术和麻醉时间短于D组。
结论 这项回顾性研究表明，在BVET期间使用双肺通气麻醉是改善肺氧合和减少麻醉时间的安全有效方法。  原始文献来源 👇 Mijung Yun, Gunn Hee Kim, Sung-chul Ko, Yun Jae Han, and Wooshik Kim.Comparison of two-lung and one-lung ventilation in bilateral video-assisted thoracoscopic extendedthymectomy in myasthenia gravis:a retrospective study.Anesth Pain Med (Seoul) 2022 Jan 06. 英文原文 Comparison of two-lung and one-lung ventilation in bilateral video-assisted thoracoscopic extendedthymectomy in myasthenia gravis:a retrospective study Abstract Background: Myasthenia gravis (MG) is an autoimmune disease, and early thymectomy is recommended. Since the introduction of video-assisted thoracoscopic surgery, the safety and effectiveness of carbon dioxide insufflation in the thoracic cavity (capnothorax) has been controversial. This study aimed to compare the safety and effectiveness of ventilation methods in bilateral video-assisted thoracoscopic extended thymectomy (BVET) with capnothorax. Methods: We retrospectively investigated the medical records of patients with MG who underwent BVET between August 2016 and January 2018. Patients were divided into two groups: group D (n = 26) for one-lung ventilation and group S (n = 28) for two-lung ventilation. We set nine anesthesia time points (T0–T8) and collected respiratory and hemodynamic variables, including arterial O2 index (PaO2/FiO2). Results: SpO2 at T1–T3 and T8 was significantly lower in group D than in group S. The FiO2 in group S was lower than that in group D at all time points. The number of PaO2/FiO2 ≤ 300 and PaO2/FiO2 ≤ 200 events was significantly higher in group D than in group S. Hemodynamic variables were not significantly different between the two groups at any time point. The duration of surgery and anesthesia was shorter in group S than in group D. Conclusions: This retrospective study suggests that anesthesia using two-lung ventilation during BVET with capnothorax is a safe and effective method to improve lung oxygenation and reduce anesthesia time. 谢谢您的点赞、分享、在看， 欢迎您的精彩评论哦 更多精彩，请关注公众号：罂粟花
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