335例纵隔肿瘤病人麻醉分析

The Anesthetic Management of the Patient with Mediastinal mass(335cases)

摘要: 目的　温故知新为纵隔肿瘤病人的麻醉提供经验和参考。方法　回顾335例纵隔肿瘤病人的麻醉过程，总结特殊纵隔肿瘤的麻醉经验。结果　多数病例麻醉过程顺利，25例出现呼吸循环危象，8例术后不能拔除气管内插管。但无一例死亡。结论　小的纵隔肿瘤麻醉处理无特殊。巨大纵隔肿瘤及纵隔肿瘤压迫气管致呼吸道梗阻患者，麻醉插管应慎重，胸腺瘤伴重症肌无力的麻醉中，中短效非去极化肌松药可以应用，但应小量分次给药。

Abstract: Objective To investigate the anesthetic management of the patient with a mediastinal mass. Methods The anesthetic management about three hundred and thirty-five cases with mediastinal mass have been retrospectively studied. Results Severe respiratory and cardiovascular complications have been found in twenty-five patients with mediastinal mass.But no death in all of the patients happened. Conclusion No special management in the patient with small mediastinal mass was neened.The patient with large mediastinal mass or airway obstruction due to a mediastinal mass is at great risk for general anesthesia.Nondepolarixing muscle relaxant can be used in patient with thymoma and myasthenia gravis.But neuromuscular transmission should be adequately monitored during and after surgery.