【临床麻醉学教案】胸科手术的麻醉

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1、课程名称：临床麻醉学教材名称：临床麻醉学第二版ClinicalAnesthesiology授课时间：授课对象：麻醉专业教学内容：胸科手术的麻醉计划学时:4重点:lateraldecubituspositionopenpneumothoraxMediastinalShiftParadoxicalRespiration难点：PhysiologicalConsiderationsduringThoracicAnesthesiaspecialconsiderationhypoxicpulmonaryvasoconstrictionplacementofadouble-lumenb

2、ronchialtube教学ri的：通过此次课使学生学握剖胸和侧卧位对病人呼吸和循环的影响；掌握胸科病人麻醉前评估与准备;掌握胸科病人手术的特点于处理;熟悉常见胸科手术的麻醉处理。教学方法：采用启发式；互动式；多进行病例的讲解和分析，帮助学生理解和记忆；教具(挂图幻灯投影及CAI等)：多媒体；实物新内容新知识(注明来源及所占比例):bronchoscopy,mediastinoscopyClinicalAnesthesiology4,hUSA(10%)MillerAnesthesia6thUSA(5%)夕卜语关键词：ThoracicAnesthesia;lateralde

3、cubitusposition;openpneumothorax;MediastinalShift;ParadoxicalRespiration;one-lungventilation;hypoxicpulmonaryvasoconstriction;bronchoscopy,mediastinoscopy;lungs;pleura;esophagus参考资料：ClinicalAnesthesiology4thUSAMillerAnesthesia6thUSA多媒体、举例10多媒体、举例课堂设计：AnesthesiaforThoracicSurgery:Introduct

4、ion15肺功能测定及动脉血气分析10PhysiologicalConsiderationsduringThoracicAnesthesiaspecialconsideration15多媒体、举例lateraldecubitusposition10多媒体、举例openpneumothorax10举例、多媒体MediastinalShift1()举例、多媒体ParadoxicalRespiration1()多媒体、举例one-lungventilation15多媒体、举例hypoxicpulmonaryvasoconstriction5多媒体、举例Factorsinhibi

5、tHPV15讲解、多媒体DOUBLE-LUMENBRONCHIALTUBES15图示、讲解麻醉前评估与准备10举例、讲解图表、讲解胸科手术麻醉的特点与处理10讲解、举例胸科手术麻醉的基本要求10讲解、举例常见胸科手术的麻醉处理10讲解、举例小结10讲解、举例、讲解术前准备10教学过程：AnesthesiaforThoracicSurgeryIntroductionIndicationsandtechniquesforthoracicsurgeryhavecontinuallyevolvedsinceitsorigins.Commonindicationsarenolong

6、errestrictedtocomplicationsoftuberculosisandsuppurativepneumonitisbutnowincludethoracicmalignancies(mainlyofthelungsandesophagus),chesttrauma,esophagealdisease,andmediastinaltumors.Diagnosticproceduressuchasbronchoscopy,mediastinoscopy,andopen-lungbiopsiesarealsoconimon.Anesthetictechniqu

7、esforseparatingtheventilationtoeachlunghaveallowedtherefinementofsurgicaltechniquestothepointthatmanyproceduresareincreasinglyperformedthoracoscopically.High-frequencyjetventilation(高频通气)andcardiopulmonarybypass(CPB)nowallowcomplexproceduressuchastrachealresectionan