摘要
目的:观察帝视观察用内窥镜(帝视内窥镜)联合可视双腔支气管导管(DLT)在胸腔镜手术中气道管理的效果。方法:依据随机数字表法对2019年7月-2020年12月在普宁华侨医院行择期胸腔镜手术的患者80例分组探究(各40例),对照组采用普通左侧DLT,试验组采用帝视内窥镜联合可视左侧DLT。静脉快速麻醉诱导后分别置入DLT,对照组通过听诊法完成定位,试验组通过帝视内窥镜联合可视双腔支气管导管壁内置摄像头完成定位。待定位完成后行纤维支气管镜确认,记录插管定位用时,计算插管一次到位成功率,术中使用纤维支气管镜次数;观察并记录插管后的血流动力学变化,记录插管定位后气道损伤及术后咽痛、声嘶发生率。结果:与对照组相比,试验组插管定位用时明显短(P<0.05),插管一次到位成功率高(P<0.05),术中使用纤维支气管镜的次数少(P<0.05);插管完成后即刻和插管完成后5 min平均动脉压较低、心率较慢(P<0.05);术后咽痛、声嘶程度低于对照组(P<0.05);气管隆突及支气管损伤严重程度轻于对照组(P<0.05)。结论:帝视内窥镜联合可视双腔支气管导管插管可安全有效应用于胸腔镜手术,值得临床推广。
Objective:To observe the effect of Discopo endoscope combined with visual double-lumen bronchial catheter (DLT) on airway management in thoracoscopic surgery.Method:According to the random number table method,80 patients who underwent elective thoracoscopic surgery in Puning Overseas Chinese Hospital from July 2019 to December 2020 were divided into groups (40 cases in each group),the control group was treated with ordinary left DLT,and the experimental group was treated with Discopo endoscope combined with visualization of left DLT.After induction of rapid intravenous anesthesia,DLT was placed respectively,the control group was positioned by auscultation,and the experimental group was positioned by a Discopo endoscope combined with a video camera built into the wall of the double-lumen bronchial catheter.After the positioning was completed,fiberoptic bronchoscopy was performed for confirmation,and the positioning time of the intubation were recorded.The success rate of intubation once in place was calculated.The hemodynamic changes after intubation were observed and recorded,the incidences of airway injury,postoperative sore throat and hoarseness after intubation positioning were compared.Result:Compared with the control group,the intubation positioning time of the experimental group were significantly shortened (P<0.05),the success rate of intubation in one place was higher (P<0.05),and the number of fiberoptic bronchoscopes used during the operation was less (P<0.05),the mean arterial pressure and heart rate were lower at immediately and 5 minutes after intubation (P<0.05).Postoperative sore throat and hoarseness were lower than those in the control group (P<0.05);tracheal carina and the severity of bronchi injury was lighter than that of the control group (P<0.05).Conclusion:Discopo endoscope combined with visual double-lumen bronchial catheter intubation can be safely and effectively used in thoracoscopic surgery,which is worthy of clinical promotion.
作者
许炎荣
邱晓涛
方创茂
陈树群
许裕杰
XU Yanrong;QIU Xiaotao;FANG Chuangmao;CHEN Shuqun;XU Yujie(Puning Overseas Chinese Hospital,Guangdong Province,Puning 515300,China;不详)
出处
《中国医学创新》
CAS
2022年第22期47-51,共5页
Medical Innovation of China
基金
揭阳市科技计划项目(2019ws062)。
