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目的探讨单腔气管插管CO_2人工气胸法用于胸腔镜食管癌根治术的安全性。方法选取胸腔镜食管癌根治术患者80例,随机分为单腔气管插管CO_2人工气胸组(A组)和双腔气管插管、单肺通气组(B组),每组40例。两组分别在气管插管前(T1)、气管插管后30min(T2)、气管插管后60min(T3)、手术结束后10min(T4)时检测MAP、SpO_2、气道压(Paw)、P_(ET)CO_2和PaCO_2;记录手术者对手术视野滿意度。结果与T1比较,两组MAP各时间点均无显著变化;A组各时间点SpO_2无明显变化,B组T3时SpO_2降低(P<0.05);两组T2、T3时Paw均增加(P<0.05);A组T3时PaCO_2、P_(ET)CO_2增加(P<0.05)。与B组比较,A组T2、T3时SpO_2、Paw、P_(ET)CO_2、PaCO_2均增高(P<0.05)。A组胸腔暴露良好,对手术操作无影响;B组胸腔暴露不佳4例。结论单腔气管插管CO_2人工气胸法用于胸腔镜食管癌根治术安全有效。
Objective To investigate the safety of single-chamber endotracheal intubation with CO_2 artificial pneumothorax for thoracoscopic esophagectomy. Methods A total of 80 patients undergoing thoracoscopic esophagectomy for radical resection were randomly divided into single-chamber tracheal intubation CO_2 artificial pneumothorax (group A) and double-lumen tracheal intubation (group B) with 40 patients in each group. The levels of MAP, SpO 2, airway pressure (Paw) were measured before intratracheal intubation (T1), tracheal intubation 30min (T2), intubation 60min (T3), and after 10min P_ (ET) CO_2 and PaCO_2; record surgeons satisfaction with surgical field of vision. Results Compared with T1, there was no significant change in MAP at each time point. There was no significant change of SpO 2 at each time point in group A, while SpO 2 at T3 was decreased in group B (P <0.05) 0.05). PaCO_2 and P_ (ET) CO_2 in group A increased at T3 (P <0.05). Compared with group B, the values of SpO_2, Paw, P_ (ET) CO_2 and PaCO_2 increased at T2 and T3 in group A (P <0.05). A group of chest exposed well, no impact on surgical procedures; B group chest poorly exposed in 4 cases. Conclusion Single-chamber endotracheal intubation CO_2 artificial pneumothorax for thoracoscopic esophageal cancer radical surgery is safe and effective.