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目的比较局部麻醉与全身麻醉下电视胸腔镜治疗恶性胸腔积液的临床疗效。方法 52例接受治疗的恶性胸腔积液患者,26例行局部麻醉下的电视胸腔镜治疗作为局部麻醉组,26例行全身麻醉下电视胸腔镜治疗作为全身麻醉组。观察两组治疗的临床效果。结果局部麻醉组患者平均手术时间15 min,心率升高15次/min,血压升高8 mm Hg(1 mm Hg=0.133 k Pa),住院时间7 d,住院费用2500元;全身麻醉组患者平均手术时间30 min,心率无明显变化,血压无明显变化,出现4例呼吸功能衰竭,住院时间12 d,住院费用7000元,两组比较差异有统计学意义(P<0.05)。在术中,两组患者的血氧饱和度均无明显变化,差异无统计学意义(P>0.05)。随访5~11个月,全部患者均无胸水复发,胸腔积液均得到控制。无一例死亡。结论局部麻醉下电视胸腔镜治疗恶性胸腔积液更加安全、创伤更小、恢复更快,手术时间更短,更加经济。
Objective To compare the clinical efficacy of video-assisted thoracoscopic surgery for malignant pleural effusion under local anesthesia and general anesthesia. Methods Twenty-two patients undergoing malignant pleural effusion underwent local anesthesia. Twenty-six patients underwent local anesthesia undergoing video-assisted thoracoscopic surgery as a local anesthesia group and 26 undergoing general anesthesia undergoing video-assisted thoracoscopic surgery as a general anesthesia group. The clinical effects of the two groups were observed. Results In the local anesthesia group, the average operation time was 15 min, the heart rate was increased 15 times / min, the blood pressure was increased by 8 mm Hg (1 mm Hg = 0.133 kPa), the hospitalization time was 7 days and the hospitalization cost was 2,500 yuan. There were no significant changes in heart rate and blood pressure during the operation time of 30 minutes. There were 4 cases of respiratory failure, 12 days of hospitalization and 7,000 yuan of hospitalization. The difference between the two groups was statistically significant (P <0.05). During operation, there was no significant change in the oxygen saturation between the two groups, with no significant difference (P> 0.05). All the patients were followed up for 5 to 11 months without pleural effusion and pleural effusion were controlled. No one died. Conclusion The video-assisted thoracoscopic treatment of malignant pleural effusion under local anesthesia is safer, less traumatic, faster recovery, shorter operation time and more economical.