无阿片类药物全麻联合超声引导下胸椎旁神经阻滞用于肺大泡切除术一例
Journal of Clinical Anesthesiology(2023)
Abstract
患者男,21岁,174 cm,65 kg,因"突发左侧胸痛伴胸闷气短8小时"入院.患者8h前无明显诱因下突发左侧胸痛,为钝痛,深呼吸、咳嗽时明显,伴胸闷气短.至我院急诊,胸部CT示:左侧大量气胸.急诊予吸氧、胸腔闭式引流排气等对症处理,拟"气胸"收入院.病程中患者一般情况良好.既往无特殊病史.查体:胸廓无畸形,左侧胸腔闭式引流管在位、通畅,无引流液体,咳嗽见大量气体溢出水封瓶,左上肺叩诊鼓音,左侧呼吸音较右侧明显减弱.未及干湿啰音.HR 86次/分,律齐,各瓣膜区未闻及病理性杂音.胸部CT示:左侧大量气胸(肺压缩约为85%).术前未查血气,生化、血常规、心电图无异常.术前诊断:左侧自发性气胸.拟在保留自主呼吸全麻下行胸腔镜左侧肺大泡切除术.
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