Background:McKeown minimally invasive esophagectomy (MIE-McKeown) is a safe and feasible surgical method. However, the conventional anesthetic management with endotracheal intubation for MIE-McKeown is associated with high respiratory morbidity. The discontinuous spontaneous ventilating anesthesia by laryngeal mask may have advantages over conventional intubated anesthesia in MIE-McKeown. This study was designed to describe the techniques and evaluate the feasibility of discontinuous spontaneous ventilating anesthesia by laryngeal mask for MIE-McKeown. Methods:Between October 2022 and September 2024, 33 patients underwent MIE-McKeown at First Affiliated Hospital of Guangzhou Medical University. The study cohort was divided into a discontinuous spontaneous ventilating anesthesia group (Group A) and an intubated anesthesia group (Group B). We retrospectively compared the characteristics and perioperative outcomes of patients who underwent MIE-McKeown. Results:The clinical characteristics of Group A were not different from Group B except for gender. Non-inferiority analysis demonstrated that in Group A, both the lowest pulse oxygen saturation (SpO2) and peak end-tidal carbon dioxide (EtCO2) during cervical and abdominal procedures were non-inferior to those in Group B. Although the peak EtCO2 during thoracic procedure was significantly higher in Group A than in Group B (57.05±9.12 vs. 45.38±3.97 mmHg, P<0.001), no severe hemodynamic changes, progressive decrease of SpO2 or requirement conversion to intubated anesthesia were observed. In Group A, pleural effusion occurred in one patient, respiratory failure occurred in one patient. In Group B, and respiratory failure occurred in two patients and paralysis of recurrent laryngeal nerve (RLN) occurred in one patient. There were no cases of perioperative mortality. Conclusions:The technique of discontinuous spontaneous ventilating anesthesia by laryngeal mask for MIE-McKeown is considered feasible. Careful evaluation of the patients, preoperative assessment and skillful surgical technique are the key factors of successful discontinuous spontaneous ventilating anesthesia by laryngeal mask for MIE-McKeown. The discontinuous spontaneous ventilating anesthesia by laryngeal mask can be a valid alternative to the conventional intubated anesthesia for MIE-McKeown.

Background:Postoperative pulmonary complications (PPCs) remain one of the common challenges in video-assisted thoracic surgeries. While tubeless anesthesia using laryngeal mask has emerged as a fast-track recovery approach, offering multiple advantages for both lungs, such as reduced anesthetic dosage, avoidance of airway injury, and facilitation of surgical manipulation, its impact on the non-operative lung remains unclear. We aim to conduct a retrospective study based on computed tomography (CT) imaging. Methods:We included lung surgery cases from January 2020 to March 2025 at The First Affiliated Hospital of Guangzhou Medical University. Pre- vs. postoperative CT reports were compared to identify novo contralateral lung abnormalities. Intraoperative respiratory parameters were collected and analyzed. Propensity score matching (PSM) was used to balance confounding factors between the tubeless anesthesia and intubated groups, followed by a conditional logistic regression model to analyze the incidence and severity of PPCs as the dependent variables, aiming to clarify the safety and efficacy of this anesthesia method. Results:After screening 140,036 surgeries, 1,294 cases were eligible. Following 2:1 PSM, 427 patients in the intubated group were matched with 234 patients in the tubeless group. The tubeless group showed lower average airway pressures (peak: 19.39 vs. 6.80 cmH2O, mean: 7.28 vs. 3.23 cmH2O, plateau: 17.88 vs. 8.03 cmH2O, all P<0.001) and ventilation parameters (tidal volume: 320.42 vs. 279.90 mL, P<0.001; minute ventilation: 4.65 vs. 3.47 L, P<0.001). For surgeries lasting 60-120 minutes, the tubeless group showed lower rates of overall CT changes (15.6% vs. 8.2% P=0.04) and consolidation (12.6% vs. 5.7% P=0.03). Postoperative hospital stay was shorter in the tubeless group (4.51 vs. 6.43 days, P<0.001). Average respiratory rate [odds ratio (OR) 1.36, 95% confidence interval (CI): 1.07-1.74, P=0.01] and minute ventilation (OR 1.32, 95% CI: 0.91-1.90, P=0.14) showed the strongest correlation with CT changes. Conclusions:Tubeless approach is associated with lower mechanical ventilation pressures and less overall image abnormalities, potentially protecting the non-operative lung. These findings suggest that tubeless approach has protective effect on the non-operative lung, contributing to the enhanced recovery after thoracic surgery.

Background: Postoperative pulmonary complications (PPCs) remain one of the common challenges in video-assisted thoracic surgeries. While tubeless anesthesia using laryngeal mask has emerged as a fast-track recovery approach, offering multiple advantages for both lungs, such as reduced anesthetic dosage, avoidance of airway injury, and facilitation of surgical manipulation, its impact on the non-operative lung remains unclear. We aim to conduct a retrospective study based on computed tomography (CT) imaging. Methods: We included lung surgery cases from January 2020 to March 2025 at The First Affiliated Hospital of Guangzhou Medical University. Pre-vs. postoperative CT reports were compared to identify novo contralateral lung abnormalities. Intraoperative respiratory parameters were collected and analyzed. Propensity score matching (PSM) was used to balance confounding factors between the tubeless anesthesia and intubated groups, followed by a conditional logistic regression model to analyze the incidence and severity of PPCs as the dependent variables, aiming to clarify the safety and efficacy of this anesthesia method. Results: After screening 140,036 surgeries, 1,294 cases were eligible. Following 2:1 PSM, 427 patients in the intubated group were matched with 234 patients in the tubeless group. The tubeless group showed lower average airway pressures (peak: 19.39 vs. 6.80 cmH(2)O, mean: 7.28 vs. 3.23 cmH2O, plateau: 17.88 vs. 8.03 cmH2O, all P<0.001) and ventilation parameters (tidal volume: 320.42 vs. 279.90 mL, P<0.001; minute ventilation: 4.65 vs. 3.47 L, P<0.001). For surgeries lasting 60-120 minutes, the tubeless group showed lower rates of overall CT changes (15.6% vs. 8.2% P=0.04) and consolidation (12.6% vs. 5.7% P=0.03). Postoperative hospital stay was shorter in the tubeless group (4.51 vs. 6.43 days, P<0.001). Average respiratory rate [odds ratio (OR) 1.36, 95% confidence interval (CI): 1.07-1.74, P=0.01] and minute ventilation (OR 1.32, 95% CI: 0.91-1.90, P=0.14) showed the strongest correlation with CT changes. Conclusions: Tubeless approach is associated with lower mechanical ventilation pressures and less overall image abnormalities, potentially protecting the non-operative lung. These findings suggest that tubeless approach has protective effect on the non-operative lung, contributing to the enhanced recovery after thoracic surgery.

BackgroundSurgeon and anesthetist share the airway in a simpler way in the resection and reconstruction phase of tracheal surgery in tubeless spontaneous-ventilation video-assisted thoracoscopic surgery (SV-VATS). Tubeless SV-VATS means stable spontaneous ventilation in the resection and reconstruction phase to anesthesiologist, and unobstructed surgical field to surgeon. What's the ideal airway management strategy during "Visual Field tubeless" SV-VATS for tracheal surgery is still an open question in the field.MethodsWe retrospectively reviewed 33 patients without sleeve and carina resections during the study period (2018-2020) in our hospital. The initial management strategy for these patients was spontaneous ventilation for intrathoracic tracheal resection and reconstruction. We obtained and reviewed medical records from our institution's clinical medical records system to evaluate the airway management strategy and device failure rate for tracheal resection in Tubeless SV-VATS.ResultsBetween 2018 and 2020, SV-VATS was first attempted in the 33 patients who had intrathoracic tracheal surgery but without sleeve and carina resections. All patients underwent bronchoscopy (33/33) and 8 patients (8/33) received partial resection before surgery. During the surgery, the airway device comprised either a ProSeal laryngeal mask airway (ProSeal LMA) (n = 27) or single lumen endotracheal tube (n = 6). During the resection and reconstruction phase, Visual Field tubeless SV-VATS failed in 9 patients, and breathing support switched to plan B which is traditional ventilation of a single lumen endotracheal tube for cross field intubation (n = 4) and ProSeal LMA alongside a high-frequency catheter (high-frequency jet ventilation, HFJV) (n = 5) into the distal trachea ventilation. Preoperative respiratory failure or other ventilation-related complications were not observed in this cohort.ConclusionBase on current analysis either ProSeal LMA or endotracheal tube is an effective airway management strategy for tubeless SV-VATS with appropriate patient selection. It also provides breathing support conversion option when there's inadequate ventilation.

患者,男,56岁,169 cm,50 kg,ASA Ⅳ级,因"反复咳嗽咳痰9年,气促4年,加重2个月"入院.2个月前咳痰、气促明显加重,予气管插管呼吸机辅助通气、抗感染、祛痰、平喘等治疗,后顺利拔除气管插管,予无创通气.既往患有焦虑症2年,长期吸烟史,约20支/天,已戒烟2个月.查体:肋间隙增宽、双肺呼吸音低.术前心脏彩超检查:三尖瓣轻度反流,左心室收缩功能正常.胸部CT检查:肺气肿,两肺多发肺大疱.术前诊断:(1)慢性阻塞性肺疾病;(2)Ⅱ型呼吸衰竭;(3)冠状动脉粥样硬化;(4)焦虑症.患者终末期肺病,经内科治疗无效,拟全麻下行序贯双肺移植术( bilateral lung transplantation, BLT).

Background:Upper tracheal surgery is used to treat patients who with tracheal tumors or tracheal stenosis. The non-intubated spontaneous ventilation anesthesia (NSVA) may have advantages over endotracheal intubation and surgical cross-field intubation in upper tracheal surgery. This study aimed to illustrate and assess the feasibility of NSVA strategy for upper tracheal surgery.Methods:This is a retrospective case series study in which 51 patients (from May 2015 to August 2020) who met the criteria in NSVA strategy were analyzed. Anesthesia was performed using total intravenous anesthesia (TIVA) combined with bilateral superficial cervical plexus block (CPB) or thoracic epidural anesthesia (TEA). Patients received spontaneous ventilation through laryngeal mask airway (LMA) during the surgery. Anesthesia conversion technique was applied to patients who met the anesthesia conversion criteria.Results:In total, 51 patients met the NSVA criteria and were included in this study. Forty-six out of 51 patients (90%) had TIVA + bilateral superficial CPB and five patients (10%) had TIVA + TEA + CPB. During the airway-opened period, 46 patients had stable spontaneous ventilation. Five patients need anesthesia conversion, two patients had high-frequency ventilation (HFV), and three patients required cross-field intubation. Postoperative complications occurred in seven (14%) patients, no reintubation was needed after surgery. The median postoperative hospital stay was 6.31±4.30 days.Conclusions:This NSVA strategy includes criteria for patient selection, preoperative assessment, surgical technique, airway management, criteria and technique for anesthesia conversion. The NSVA strategy is a feasible procedure in upper tracheal surgery.

An introduction of tubeless anesthesia for thoracic surgery in different aspects including airway management, pathophysiologic alteration, monitoring, types of anesthesia drugs, and potential complications.

目的 探讨终末期慢性阻塞性肺疾病(COPD)患者单肺移植术后手术室内气管拔管方案的可行性及安全性.方法 回顾性分析57例因终末期COPD行单肺移植的受者的临床资料,根据本院制定的手术室内气管拔管评估指标进行评估,符合条件、在手术室完成气管拔管的为手术室拔管组(OR拔管组,17例),在重症监护室(ICU)完成气管拔管的为ICU拔管组(40例).比较两组术中气管拔管评估结果和术后康复情况.结果 与ICU拔管组比较,OR拔管组受者的氧合指数较高,动脉血二氧化碳分压(PaCO2)、血乳酸水平较低,血压波动幅度较小,术中使用体外膜肺氧合(ECMO)的例数较少(均为P<0.05).OR拔管组2例受者分别于返回ICU 6、8 h再次气管插管,术后6、9 d拔除气管导管.OR拔管组受者术后机械通气时间、术后ICU入住时间、术后住院时间均较ICU拔管组受者短(均为P<0.05).两组受者术后原发性移植物功能障碍(PGD)3级、房性快速性心律失常、连续肾脏替代治疗例数和1年生存率比较,差异均无统计学意义(均为P>0.05).结论 本院制定的COPD患者单肺移植术后手术室内气管拔管方案安全可行,可减少受者术后机械通气时间,缩短术后ICU入住时间及住院时间,不增加并发症发生率.

Objective:To investigate the clinical effect of dexmedetomidine combined with ultrasound-guided sacral canal block in the high ligation of laparoscopic hernia sac in children.Methods:90 cases of children undergoing laparoscopic high ligation of hernia sac in Lu’an People’s Hospital from January 2018 to December 2019 were prospectively included. All the children were divided into two groups by random number method. The conventional group received sacral block anesthesia with ropivacaine, and the combination group received sacral block anesthesia with dexmedetomidine plus ropivacaine. The operative time, recovery time、observation time in the resuscitation room and maintenance time of analgesia were compared between the two groups. Hemodynamics, including heart rate and mean arterial pressure, were compared between the two groups at pre-anesthesia (T1), post-sacral block (T2), dermectomy (T3), surgical completion (T4), tracheal catheter removal (T5), and 10 minutes after resuscitation (T6). The agitation of the two groups during the waking period was compared, including the incidence of agitation and the agitation score.Results:There were no significant differences in operation time, recovery time and observation time in recovery room between the two groups. The analgesia maintenance time in the conventional group was significantly shorter than that of the combination group (P<0.05). There were no significant differences in HR and MAP between the two groups at T1. HR of the combination group was significantly lower than that of the conventional group from T3 to T5 (P<0.05). MAP level in the combination group was lower than that of the conventional group at T5-T6 (P<0.05). The incidence of restlessness in the conventional group was 22.2%, which was significantly higher than that of the combination group (6.7%) (P<0.05). The agitation score of the combination group was significantly lower than that of the conventional group (P<0.05).Conclusion:The application of dexmedetomidine combined with ultrasound guided anesthesia in the high ligation of laparoscopic hernia sac in children can reduce the stress response of the body during the operation, maintain a more stable hemodynamic state, effectively reduce the occurrence of postoperative agitation during the recovery period, and improve the quality of the recovery period.

Jianxing He, Hengrui Liang, Wei Wang, Andrey Akopov, Alberto Aiolfi, Keng-Leong Ang, Luca Bertolaccini, Kaican Cai, Qingdong Cao, Baojun Chen, Chang Chen, Chun Chen, Donglai Chen, Fengxia Chen, Jun Chen, Lei Chen, Mingwu Chen, Yongbing Chen, Zhuxing Chen, Chao Cheng, Dong Cui, Fei Cui, Tianyang Dai, Qinglong Dong, Paolo A. Ferrari, Raja M. Flores, Junke Fu, Soichiro Funaki, Marios E. Froudarakis, Xiangfeng Gan, Mingfei Geng, Jialong Guo, Qiang Guo, Yongtao Han, Jintao He, Kaiming He, Kyoji Hirai, Jian Hu, Shuqiao Hu, Jian Huang, Jun Huang, Wenfa Jiang, Kyung Soo Kim, Gabor Kiss, Fanyi Kong, Lan Lan, Xuefeng Leng, Bin Li, Gaofeng Li, Hecheng Li, Hefei Li, Heng Li, Jiwei Li, Xiaoqiang Li, Shuben Li, Yinfen Li, Zhuoyi Li, Yi Liang, Lixia Liang, Wenhua Liang, Yongde Liao, Wanli Lin, Xu Lin, Hongxu Liu, Hui Liu, Jixian Liu, Jun Liu, Xiang Liu, Zihao Liu, Xingzhao Lu, Qingquan Luo, Naiquan Mao, Qi Pan, Dazhi Pang, Jun Peng, Jun Peng, Eugenio Pompeo, Rulin Qian, Kun Qiao, Bassam Redwan, Zi Sang, Wenlong Shao, Jianfei Shen, Weiyu Shen, Sook-Whan Sung, Wenfang Tang, Tianhu Wang, Guangsuo Wang, Haitao Wang, Huien Wang, Jiyong Wang, Wen Wang, Yongyong Wang, Zhenyuan Wang, Li Wei, Wei Wei, Hao Wu, Jie Wu, Zhaohua Xia, Chenyang Xu, Enwu Xu, Hai Xu, Ning Xu, Quan Xu, Rongyu Xu, Shun Xu, Chaokun Yang, Hanyu Yang, Shengli Yang, Jun Yi, Guangjian Zhang, Hao Zhang, Jia Zhang, Man Zhang, Xiao Zhang, Yajie Zhang, Zhe Zhang, Zhifeng Zhang, Honglin Zhao, Jian Zhao, Xiaodong Zhao, Jianping Zhou, Yanran Zhou, Chengchu Zhu, Shaojin Zhu, Xinhai Zhu, Jian Cui, Yubo Yan, Ke-Neng Chen

目的:探讨基于微信公众平台的医-护-志愿者联动健康教育模式对妊娠期糖尿病患者的管理效果.方法:随机选取2017年1月～2019年9月,在广州医科大学附属第三医院定期产检且确诊为妊娠期糖尿病患者共943例,其中对照组468人,干预组475人.对照组采用常规门诊教育模式,干预组采用基于微信平台医-护-志愿者健康教育模式进行干预.比较两组的自我管理能力,血糖控制情况、妊娠结局等.结果:两组患者在干预后的生理指标、孕期增重管理达标率、分娩结局比较、自我管理水平较干预前有所改善,差异有统计学意义(P<0.05).结论:基于微信公众平台的医-护-志愿者健康教育模式,可有效提高妊娠期糖尿病患者自我管理能力、控制血糖水平血糖,降低不良妊娠结局的发生率.有利于实现医、护、患、志愿者之间的多向沟通,提高医护的工作效率,实现对妊娠期糖尿病患者系统、高效、连续性的全程孕期管控,此模式值得推广使用.

Objective:To observe the incidence of residual neuromuscular blockade at the end of operation and during tracheal extubation, and analyze the risk factors causing residual neuromuscular blockade by judging the degree of muscle relaxation according to clinical signs when after using rocuronium or cis-atracurium in general anesthesia.Methods: 500 adults were implemented with propofol-remifentanil intravenous anesthesia or sevoflurane inhalation anesthesia. Rocuronium and cis-atracurium were given, respectively. The TOFr was observed with blind method by TOF Watch SX monitor during anesthesia.Results: The mean TOFr=0.53±0.38 at the end of operation,including 275 cases of 0

Objective:To establish the pig lung transplant model from the donation after cardiac death, and reveal the recovery effect of Ex vivo lung perfusion (EVLP) in lung injury.Methods:Sixteen pigs involved in the experiment, 8 in experimental group and 8 in control group. Pigs were induced the cardiac death by removing the oxygen after tracheal intubation. At 10 h of 4℃ storage after the procurement, the donor lungs were connected to the EVLP system, the oxygenation index, airway pressure, pulmonary vascular resistance, pulmonary compliance and left atrial pressure were detected, and then the donor lungs were transplanted into the recipient pigs. The recovery effect of Ex vivo lung perfusion in donor lung injury was evaluated. The t test, Kruskal-Wallis test and Chi-square test were used to carry out the statistical analysis and SPSS 22 was used to finish the data processing. Results:In the EVLP experiment, the oxygenation index increased obviously, which was (279.0±17.0) and (442.5±17.5) mmHg at 1st and 4th h (1 mmHg=0.133 kPa, t=15.176, F=0.146, P<0.01), respectively. The pulmonary vascular resistance decreased obviously, which was (571.43±57.14) dynes/s/cm5 and (314.29±28.58) dynes/s/cm 5 at 1st and 4th h ( t=9.258, F=2.455, P<0.01), respectively. The pressure of pulmonary artery also decrease obviously, which was (14.0±1.0) and (8.5±0.5) mmHg at 1st and 4th h ( t=12.011, F=0.158, P<0.01), respectively. The airway pressure also decrease, which was (17.0±1.0) and (12.5±0.5) cmH 2O at 1st and 4th h (1 cmH 2O=0.098 kPa, t=8.878, F=0.158, P<0.01), respectively. With the high baseline, the oxygenation index was also steady in experimental group compared to the control group, especially after 120 min. Conclusion:The method explored above to establish the pig model with EVLP from the donation after cardiac death is feasible and repeatable.

Background To compare the safety and feasibility of ultrasound-guided thoracic paravertebral blockade (TPVB) and internal intercostal nerve block (IINB) for non-intubated video-assisted thoracic surgery (NIVATS). Methods Thirty-four patients who underwent NIVATS from April 2016 to May 2017 were retrospectively reviewed and divided into two groups consecutively according to local analgesia treatment, of which 20 patients received TPVB (P group) and the remaining 14 received IINB (I group). A Propensity Score Matching (PSM) analysis was performed to control the selection bias due to nonrandom assignment. Results The procedure of propensity scores yielded 2 matched cohorts of 14 patients. There were no significant differences between the two groups regarding gender, age, BMI, and surgical types (P>0.05). Blood-gas analysis 15 minutes after opening the chest showed significantly lower PaCO2 in the P group compared to the I group (P=0.004). The consumption of propofol from anesthesia induction to 15 minutes after opening the chest was also lower in the P group compared with the I group (P=0.012). There were no significant differences in the duration of surgery and visual analogue scale (VAS) pain scores between the two groups (P>0.05). Conclusions Ultrasound-guided TPVB can provide safe and reliable local anesthesia for NIVATS.

With the development of minimally invasive thoracoscopic and anesthesia control techniques, intravenous anesthesia with spontaneous ventilation video-assisted thoracic surgery (SV-VATS) has been increasingly employed in management of pleural effusion, bullectomy for pneumothorax, mediastinal biopsy, thymectomy and thymomectomy, wedge lung resections, anatomical lung resections for radical treatment of lung cancer and even more complex surgical procedures including tracheal resection and sleeve lobectomy (1-7) This changes in surgical strategies have been applied in the believe that SV-VATS can avoid adverse effects of mechanical ventilation and the residual effects of muscle relaxants, can achieve a faster recovery of respiratory muscle function and lower operative morbidity (7,8).

Objective To eva1uate the effect of gestationa1 diabetes me11itus ( GDM) education and 1earning on gestationa1 diabetes me11itus ( gestationa1 diabetes me11itus ( GDM) education using dietary counting p1ates for c1inica1 practice nurses. Methods A tota1 of 60 nurse interns from January 2015 to January 2016 were se1ected and were ran-dom1y divided into the experimenta1 group and the contro1 group, 30 nurses each. After comp1eting the basic theory of medica1 nutrition of GDM simu1taneous1y, the experimenta1 group used the diet ca1cu1ation p1ate, the contro1 group used the conventiona1 teaching video and picture teaching for 3 hours, and the teaching effect was assessed 1 hour, 1 week and 1 month after 1earning. Results 1 hour after study, the pass rate of the study group was higher than that of the contro1 group. After 1 week and 1 month of study, the number of qua1ified students and the passing rate decreased, and the number of qua1ified students in the study group was significant1y higher than that in the contro1 group, with statisti-ca11y significant differences (P<0. 05). Conclusions The effect of using diet ca1cu1ating p1ate to train trainee nurses on GDM medica1 nutrition education is better than the traditiona1 method, which is worth popu1arizing.

例1患者,男,61岁,因“反复咳嗽、咳痰、气促30余年,加重1年”入院.诊断:(1)慢性阻塞性肺疾病,(2)高血压3级,(3)2型糖尿病.拟在全麻下行“同种异体右侧单肺移植术”.查体:呼吸促,听诊双肺弥漫性呼吸双相干哕音.动脉血气:FiO233％,PaO2 122.9 mmHg,PaCO2 36.8 mmHg.肺功能:极重度混合性肺通气功能障碍(FEV1占预计值24％,FEV1/FVC 37％,FVC占预计值68％).胸部X线片和CT示:桶状胸,两肺透亮度增高,两肺纹理增粗、增多、紊乱,符合慢性支气管炎、肺气肿;两肺多发肺大泡形成.肺灌注:双肺多发灌注功能受损,左肺占51％,右肺占48％.右心导管检查:肺动脉收缩压34 mmHg.心脏彩超无异常.

阐述同伴支持的概念及主要作用,从实施步骤、传媒形式方面综述同伴支持模式在健康教育中的应用现状,分析当前形式的利弊,探讨构建更加完备同伴支持网络架构.

Background Spontaneous breathing anesthesia (SBA) may have advantages over general anesthesia for cervical tracheal resection and reconstruction (TRR), avoiding the difficulties and complication caused by endotracheal intubation and surgical cross-field intubation. This prospective study evaluates SBA for cervical TRR. Methods Date was obtained from 35 patients who had cervical TRR under SBA from May 2015 to March 2019. Intravenous sedation and ultrasound-guided bilateral superficial cervical plexus block (CPB) were applied to maintain effective analgesia and sedation. Results Thirty-two patients with tracheal tumors and 3 patients with post-intubation tracheal stenosis underwent TRR. After the airway was opened, 29 patients resumed stable spontaneous breathing, 1 patient needed high-frequency jet ventilation, and 1 patient needed anesthesia conversion for surgical reasons. Conclusions Spontaneous breathing anesthesia is feasible for the cervical TRR. It can be an alternative anesthetic technique for certain patients.

体外肺灌注(ex vivo lung perfusion,EVLP)可在离体状态下精确再评估供肺功能并修复肺损伤,改善了肺移植中供肺不足的局面[1].但实施EVLP的高昂费用限制了该技术在我国的应用.我们尝试将EVLP的核心环节国产化以降低应用成本并进行了临床前研究,成功地修复了边缘供肺[2].根据我们的初步估算,其成本可控制在原进口系统费用的1/15~1/10.在此基础上,我们将该国产化EVLP技术应用于临床,患者移植术后顺利出院,现将经验报告如下.