摘要
目的探讨右侧可视双腔气管导管(visual double lumen tube,VDLT)插管与右侧普通双腔气管导管(double lumen tube,DLT)插管在肺隔离技术中的差异,为临床提供参考。方法选择湖南省郴州市第一人民医院与四川大学华西医院2020年6月—2021年6月行右侧DLT肺隔离技术的胸腔镜手术患者57例。采用随机化分组方案,通过电脑生成随机数字,采用随机数字表将受试者按照1∶1随机分为DLT组[29例,其中男16例、女13例,平均年龄(54.3±13.2)岁]和VDLT组[28例,其中男18例、女10例,平均年龄(55.1±13.7)岁]。比较两组患者的临床资料。结果与DLT组比较,VDLT组导管定位时间明显缩短[(74.9±47.5)s vs.(151.6±88.9)s,P<0.001],右上肺堵塞率(21.4%vs.51.7%)及术中再次调整导管率(14.3%vs.48.3%)均明显降低(P<0.05)。进胸腔即刻肺塌陷质量(67.9%vs.24.1%)及进胸腔20 min肺塌陷质量(100.0%vs.75.9%)均明显改善(P<0.05)。两组术中需借助纤维支气管镜完成定位以及术后24 h咽痛、声音嘶哑发生率差异无统计学意义(P>0.05)。结论与普通DLT比较,VDLT在右侧支气管插管定位中更高效、准确、直观。
Objective To compare the clinical efficacy between right visual double lumen tube(VDLT intubation and right common double lumen tube(DLT)intubation in lung isolation technique.Methods A total of 57patients undergoing thoracoscopic surgery with right DLT lung isolation technique in the First People’s Hospital of Chenzhou City and West China Hospital from June 2020 to June 2021 were randomly divided into two groups:a DLT group(n=29,16 males and 13 females,with a mean age of 54.3±13.2 years)and a VDLT group(n=28,18 males and 10females,with a mean age of 55.1±13.7 years)at 1:1 with random number table generated by the computer.The clinical data of the two groups were compared.Results Compared with the DLT group,the catheter positioning time in the VDLT group was statistically shorter(74.9±47.5 s vs.151.6±88.9 s,P<0.001),the right upper lung occlusion rate(21.4%vs.51.7%)and the intraoperative re-adjustment catheterization rate(14.3%vs.48.3%)were lower(P<0.05).The quality of lung collapses immediately after thoracotomy(67.9%vs.24.1%)and 20 minutes after thoracotomy(100.0%vs.75.9%)were improved(P<0.05).There was no significant difference in the rate of fiberoptic bronchoscope assistance for positioning,or the incidence of pharynx pain and hoarseness between the two groups(P>0.05).Conclusion Compared with common DLT,VDLT is more efficient,accurate and intuitive in the location of right bronchial intubation.
作者
刘琦
沈诚
李晓强
万玉文
LIU Qi;SHEN Cheng;LI Xiaoqiang;WAN Yuwen(Department of Anesthesiology,First People's Hospital of Chenzhou City,Chenzhou,423000,Hunan,P.R.China;Department of Thoracic Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)
出处
《中国胸心血管外科临床杂志》
CSCD
北大核心
2023年第2期286-290,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词
双腔气管插管
可视双腔气管导管
听诊法
肺隔离
Double lumen endotracheal tube
visual double lumen endotracheal tube
auscultation
pulmonary isolation
