50例全机器人房间隔缺损修补术的麻醉方法总结.doc

50例全机器人房间隔缺损修补术的麻醉方法总结 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：50例全机器人房间隔缺损修补术的麻醉方法总结 1 1 资料与方法 3 2 结 果 4 3 讨 论 5 文2：50例全机器人房间隔缺损修补术的麻醉方法总结 8 1 资料与方法 9 2 结 果 11 3 讨 论 11 参考文摘引言： 14 原创性声明（模板） 16 文章致谢（模板） 16 正文 50例全机器人房间隔缺损修补术的麻醉方法总结 文1：50例全机器人房间隔缺损修补术的麻醉方法总结 Abstract: OBJECTIVE To summerize the anesthesia for the atrial septal defect(ASD) repair with da vinci S system under cardiopulmonary bypass (CPB). METHODS Fifty patients were underwent general anesthesia for the repair of ASD using da vinci S system under CPB. Anesthesia was induced with etomidate, lidocaine, sulfentanyl and pencuronium. A left-sided double-lumen endotracheal tube was positioned to allow single-lung ventilation post induction. Traesophageal echocardiography (TEE), bispectral index (BIS), hemodynamics and blood gas were routinely monitored. RESULTS All patients ASD was repaired with da vinci S system, no hospital mortality. Most patients could tolerate single-lung ventilation before CPB, however fourteen patients had hypoxaemia after CPB, who needed to be treated by continuous positive alveolar pressure(CPAP) itrument or double-lungs ventilation. The time of anesthesia was （±） min, aortic cross-clamp was （±）min, CPB was （±） min, tracheal intubation was （±） h, ICU stay was （±） d and post-operative hospital stay was （±） d. The volume of intra operative blood lose was （±） ml, the volume of post operative drainage was （±) ml. CONCLUSION The anesthesia for the repair of ASD with da vinci S system is comlicated because of the extremely itable hemodynamics and respiratory function during CO2 pneumothorax and single-lung ventilation, which is a new challenge for the technology and management of anesthesia. Key words： Anesthesia；Cardiac surgery；Robotic；da Vinci S System；Cardiopulmonary bypass 现代 医学在微创外科领域 发展 迅猛。常规心脏手术需要正中开胸，手术创伤大且切口不美观。2000年由美国Intuitive Surgical 公司研制开发的机器人手术系统（da Vinci S 手术系统）应用于心脏外科，使医生在不开胸的情况下能够精确的完成心脏内的手术操作，手术创伤小，术后恢复快［1］。整个手术过程是在密闭的胸腔内进行，术中需要单肺通气