左双腔支气管导管用于肺癌手术的临床观察  

Application of left-sided double-lumen endotrachacheal tubes during thoracic surgery for lung cancer

作　　者：马长青[1] 

机构地区：[1]天津医科大学附属肿瘤医院麻醉科,天津300060

出　　处：《肿瘤防治杂志》2005年第15期1178-1179,共2页China Journal of Cancer Prevention and Treatment

摘　　要：为了确定Robertshaw左双腔支气管导管(double lumen tube,DLT)插入深度距门齿的距离,为临床应用提供简便有用的参考。选择肺癌手术患者93例,经静脉快速诱导麻醉后,通过听诊法确定左DLT管端至门齿的平均距离。结果93例患者中,89例听诊法定位准确,占95.6%;4例借助纤维支气管镜定位。联接左、右导管各自分别通气时,通气侧肺泡呼吸音清晰,而对侧无肺泡呼吸音,导管气囊充气后,左右肺通气阻力均小于25cmH2O,纤维支气管镜定位平均深度男女分别为(29.6±1.5)cm和(28.0±1.5)cm。初步研究结果显示,听诊法确定左DLT在肺癌手术的临床应用简单易行,定位准确。Double lumen tube （DLT） intubation were used much more common than ever during thoracic surgery in cancer patiens. The method of auscultation to breath sounds and the use of fiberoptic bronchoscope （FOB） were compared to determine precise left- sided DI.T position. Methods： Ninety-three patiens underwent pulmonary resection for lung cancer. After fast induced by IV anesthetic and muscle relaxants, left-sided DLT （Portex, USA）was intubated. By auscultation, the lumen tip was adjusted to the proper place to separate the two lungs, and then FOB conforming the precise DLT position. The depth of insertion from the incisor tooth to the tips of left-sided DLT was recorded. Results： Eighty-nine patiens （95. 6 %） got a correct DIrT position by auscultation without replacing the DLT through FOB, and the breath sounds were normal and the expected unilateral pattern was followed with unilateral clamping, and the peak pressure of airway of the ventilated lung was less than 25 cmH20. The other 4 patients could not be inserted into the left bronchial without the direction of FOB. The mean depth of insertion was （29.6±1.5） cm in male, and （28. 0±1.5） cm in female. Conclusion： Auscultation is a practicable and convenience method to properly position the left DLT in clinical application.

关 键 词：肺肿瘤/外科学 插管法 气管内 监测 手术中 体位 

分 类 号：R734.2[医药卫生—肿瘤]