摘要
目的比较单腔支气管导管联合支气管封堵器与双腔支气管导管(DLT)在开胸手术患者单肺通气(OLV)中的应用效果。方法选取2014年1月-2018年1月在梧州市红十字会医院行开胸手术并OLV的患者60例,采用随机数字表法分为对照组和试验组,每组30例。对照组患者采用DLT插管,试验组患者采用单腔支气管导管插管并联合使用支气管封堵器。比较两组患者插管时间、插管次数、纤维支气管镜定位时间、肺萎缩满意度、动脉血氧分压(PaO2)、静脉血氧分压(PvO2)、肺血分流率(Qs/Qt)及肺动态顺应性(CLdyn),并观察两组患者术后并发症发生情况。结果试验组患者插管时间、纤维支气管镜定位时间短于对照组,插管次数少于对照组(P<0.05)。两组患者肺萎缩满意度比较,差异无统计学意义(P>0.05)。试验组患者PaO2、PvO2、Qs/Qt低于对照组,CLdyn高于对照组(P<0.05)。试验组患者术后咽痛、气管黏膜损伤及声音嘶哑发生率低于对照组(P<0.05)。结论与DLT相比,单腔支气管导管联合支气管封堵管可有效缩短开胸手术患者OLV插管时间和纤维支气管镜定位时间,减少插管次数,改善患者呼吸力学,且安全性较高。
Objective To compare the application effect on one-lung ventilation(OLV)in patients undergoing thoracotomy between single-lumen endotracheal tube combined with bronchial occlusive device and double-lumen endotracheal tube(DLT). Methods A total of 60 patients underwent thoracotomy with OLV were selected in Wuzhou Red Cross Hospital from January 2014 to January 2018,and they were divided into control group and experiment group according to random number table method,with 30 cases in each group. Patients in control group received DLT for intubation,while patients in experiment group received single-lumen endotracheal tube for intubation combined with bronchial occlusive device. Intubation time,number of intubation,fibrobronchoscopy positioning time,degree of satisfaction of pulmonary atrophy,PaO2,PvO2,Qs/Qt,CLdyn were compared between the two groups,and incidence of postoperative complications was observed. Results Intubation time and fibrobronchoscopy positioning time in experiment group were statistically significantly shorter than those in control group,meanwhile number of intubation in experiment group was statistically significantly less than that in control group(P<0.05).There was no statistically significant difference in degree of satisfaction of pulmonary atrophy between the two groups(P>0.05). PaO2,PvO2 and Qs/Qt in experiment group were statistically significantly lower than those in control group,while CLdyn in experiment group was statistically significantly higher than that in control group(P<0.05). Incidence of postoperative pharyngalgia,tracheal mucosa injury and hoarseness in experiment group was statistically significantly lower than that in control group,respectively(P<0.05). Conclusion Compared with DLT,single-lumen endotracheal tube combined with bronchial occlusive device can effevtively shorten the intubation time and fibrobronchoscopy positioning time in patients undergoing thoracotomy with OLV,as well as reduce the number of intubation and improve the breathing mechanics,with higher safety.
作者
黄胜
欧智
陈琦妮
陈世鸿
梁明锋
HUANG Sheng;OU Zhi;CHEN Qini;CHEN Shihong;LIANG Mingfeng(Department of Anesthesiology,Wuzhou Red Cross Hospital,Wuzhou 543002,China)
出处
《实用心脑肺血管病杂志》
2019年第12期79-82,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
肺通气
胸外科手术
单腔支气管导管
支气管封堵管
双腔支气管导管
疗效比较研究
Pulmonary ventilation
Thoracic surgical procedures
Single-lumen endotracheal tube
Bronchial occlusive device
Double-lumen endotracheal tube
Comparative effectiveness research
