多原发非小细胞肺癌手术治疗的麻醉策略优化

S. N. Tikhonova, D. A. Rozenko, N. D. Ushakova, N. Popova, A. M. Skopintsev, A. Shulga, I. A. Ten
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引用次数: 2

摘要

本文报告一例肺多发原发性恶性病变(左肺癌、中枢性支气管周围结节性肿瘤累及主支气管上叶和远端)的手术治疗的临床病例;右肺癌,中央肿瘤累及上叶支气管)。根治性治疗成为可能,因为使用两种通气机制完全不同的设备,利用两肺的人工气体交换的潜力。通过容积和高频肺通气对低氧血症进行功能矫正的最佳策略的选择,可以避免通气/灌注比的不平衡,防止危及生命的并发症的发生,并确保患者在手术治疗期间有足够的气体交换。
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Optimization of anesthetic tactics in the surgical treatment of multiple primary non-small cell lung cancer
The article describes a clinical case of surgical treatment of a patient with multiple primary malignant lesions of the lungs (cancer of the left lung, central peribronchial nodular tumor with involvement of the upper lobe and distal parts of the main bronchus; cancer of the right lung, central tumor with involvement of the upper lobar bronchus). Radical treatment became possible due to using the potential of artifi cial gas exchange of both lungs with two devices with fundamentally different ventilation mechanics. The choice of an optimal tactics for the functional correction of the supposed hypoxemia by volumetric and high-frequency pulmonary ventilation allowed avoiding an imbalance in the ventilation/perfusion ratio and preventing the development of life-threatening complications, as well as ensured an adequate gas exchange for the patient during surgical treatment.
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