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目的 总结６８ 例延髓占位性病变手术治疗后呼吸功能障碍的发生与处理经验。方法 对６８ 例延髓占位性病变进行了显微手术治疗， 术中采用了保留自主呼吸的麻醉方法， 应用 Ｌ Ｅ Ｏ Ｎ Ａ Ｒ Ｄ Ｏ 呼吸监测系统持续观察呼吸变化。对不同性质、不同部位的肿瘤术中术后呼吸功能的变化进行对比分析。结果 ７ 例良性肿瘤在术后３ 天内表现出轻微的中枢性低通气， 但预后良好。１２ 例有明显边界的恶性胶质瘤（ 星形细胞瘤， 室管膜瘤） 在术后表现出明显的中枢性低通气和吞咽困难，在术后４８ 小时内行气管切开术， 予间断呼吸机辅助通气， 预后良好。结论 良性或有明显边界的恶性肿瘤， 术后早期可有低通气， 但呼吸功能恢复较好； 对位于延髓闩部的恶性胶质瘤， 术后可发生呼吸功能障碍， 手术治疗应慎重
Objective To summarize the experience of treatment and treatment of respiratory dysfunction in 68 cases of medullary mass lesions after operation. Methods 68 cases of bulbar medullary lesions were treated by microsurgery. Intraoperative anesthesia was used to maintain spontaneous breathing. The respiratory changes were monitored continuously with L E O N A R D O respiration monitoring system. The changes of postoperative respiratory function in different types and locations of tumor were compared and analyzed. Results Seven cases of benign tumors showed slight central hypoventilation within 3 days after operation, but the prognosis was good. Glioma (astrocytoma, ependymomas) with obvious border in 12 cases showed obvious central hypoventilation and dysphagia after operation. Tracheotomy was performed within 48 hours after operation, and intermittent respiration Machine-assisted ventilation, the prognosis is good. Conclusions Malignant tumors with benign or obvious border may have low ventilation in the early postoperative period but good respiratory function recovery. For malignant gliomas located in the medullary bulbar portion, respiratory dysfunction may occur after operation, and surgical treatment should be cautious