36例阑尾炎继发穿孔手术临床分析.docx

36例阑尾炎继发穿孔手术临床分析.doc25例小儿房间隔、室间隔缺损胸腔镜手术麻醉处理【摘要】目的探讨2-10岁儿童房室缺修补胸腔镜手术麻醉处理方法。方法采纳单腔气管插管、静脉复合麻醉，麻醉维持采用异丙酚36mg(kgh),持续输注，分次赐予芬太尼镇痛，微泵输注维库浪镂维持肌松。术中行上下腔套带及主动脉灌注插管时，对心率、氧饱和度、平均动脉压、二氧化碳分压进行视察。结果全组手术均获得胜利，无死亡。结论术中改良双肺肺通气、加强呼吸管理和肺爱护是麻醉管理的关键。【关键词】房间隔缺损；室间隔缺损；胸腔镜手术；麻醉；小儿Abstract:ObjectiveToexploreapproachesofanesthesiamanagementofthoracoScopicsurgeryforchildren(aged2tol0)Sufferingfromatrioventricularisconimunis.MethodslntravenouscombinedanesthesiawasperformedbysinglelumenendotrachealintubationduringoperationinalIpatients.Anesthesiawasmaintainedbycontinuousinfusionofpropofol3-6mg/kgh,Withfentanyladministeredattimesforabirritationandvecuroniumbromideinfusedthroughatiny-pumpformusclerelaxationmaintenance.ResultsTherewerenomortalityandseriouscomplicationassociatedwithprocedures.Theheartrate,oxygensaturation,meanarIerialpressureandpartialPressureofcarbondIoxideduringtheoperationofaortIcperfusioncanulawereobservedandtwo-WayANOVAwasconducted.ConcIusionDuringthevideo-assiStedthoracoscopicsurgery(VATS)forpediatriccongenitaicardiopathy,improvedpulmonaryventiIation,enhancedmanagementofrespirationandlungprotectionarethekeyfaCtorsintheanesthesiamanagement.Keywords:Htrialseptaldefect;Ventricularseptaldefect;thoracoscopicsurgery;anesthesia;youngchildren胸骨正中切口心脏直视手术，具有良好的术野显露、避开对肺的挤压和损伤、有利于术后肺功能复原等优点，为胸前心内直视手术的常规入路口。但其须要纵劈胸骨，手术切口长，出血较多，存在胸骨或纵隔感染等并发症，特殊是儿童患者常引起胸骨愈合后畸形，影响术后生活质量。近年来，电视胸腔镜下心脏手术成为一种新的术式，同时也对其麻醉方法提出新的要求。我院小儿心脏微创外科2007年至今共完成小儿房间隔、室间隔缺损胸腔镜手术25例，现将麻醉处理报道如下。1资料和方法1.1一般资料男15例，女10例；年龄67岁，平均6.5岁；房间隔缺损10例，室间隔缺损15例；体重10-40kg,平.