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目的：探讨胸腔镜辅助下小切口二尖瓣罝换或成形术后呼吸道的管理。方法：从2012年7月至2013年8月开展胸腔镜辅助下小切口二尖瓣罝换或成形术共24粒，通过对患者的呼吸道的有效管理管理，如术前教会患者有效呼吸及咳嗽；术后呼吸机运用注意加温、加湿；早期拔除气管插管；术后鼓励患者有效咳嗽；加强体疗、拍背；鼓励患者早期下床活动。术后第一天、转入病房后第二或第三天复查床旁胸片及听诊双肺呼吸音。观察患者指脉氧饱和度、氧合指数、痰的颜色、量、性状、输血量、手术切口。结果：胸腔镜辅助下小切口二尖瓣罝换术后一例患者发生右侧胸腔积液，穿刺抽出淡血性胸腔积液200ml ，其余患者无胸腔积液。术后当天及返病房时听诊右侧呼吸音稍低，术后第三至四天呼吸音正常。术后患者指脉氧维持在92％～99％。氧合指数＞300。患者监护室痰量在5-10ml ，为白色粘稠痰。术后住院时间较常规二尖瓣手术短，患者恢复较快，输血少，美观等特点。结论：加强胸腔镜辅助下小切口二尖瓣罝换或成形术后呼吸道的管理能有效的降低呼吸道并发症的发生，有效的缩短住院时间，对促进患者恢复至关重要。“,”Objective :to study the thoracoscope assisted small incision after mitral valve coffret change or the management of respiratory tract . Methods :from July 2012 to August 2013 in thoracoscope assisted small incision mitral valve coffret or keratoplasty ,a total of 24 bits ,through to the effective management of patients with respiratory tract management ,such as preoperative patients effective breathing and coughing ;Postoperative res-pirator use note heating ,humidification .Postoperative early endotracheal intubation ;Patients with postoperative encourage effective cough ;Strengthe-ning exercises ,take back ;Encourage patients early ambulation .On the first day after operation ,turn into the second or third day after wards review bedside chest radiographs and double lung auscultation breath sounds .The pulse oxygen saturation ,oxygenation index were observed ,the color of phlegm ,quantity ,character ,blood transfusion amount ,incision .Results :the thoracoscope assisted small incision mitral valve coffret ,occurred in the postoperative patient right pleural effusion puncture extraction light hemorrhagic effusions 200 ml ,the rest of the patients with pleural effusion .Post-operative day and returned to the ward when auscultate breath sounds on the right is a bit low ,3 to 4 days after normal breath sounds .Postoperatively , refers to the pulse oxygen maintained at 92% ~ 99% .Oxygenation index > 300 .Patient care in 5 -10 ml ,sputum volume for white viscous sputum . Shorter postoperative hospital stay compared with the conventional mitral valve surgery ,patients recover faster ,less blood transfusion ,aesthetics ,etc . Conclusion :to strengthen the thoracoscope assisted small incision after mitral valve coffret or change of respiratory tract management can effectively reduce respiratory complications ,effective shorten hospitalization time ,is very important to promote patients recover .