侧卧位纤支镜引导下插入支气管阻断器行单肺通气的临床观察  

Clinical obsevation of bronchial blocker (BB)inset guided by fiber-optic bronchoscope (FOB)during one lung ventilation(OLV) of lateral postion

作　　者：杜建龙 包梅芳 张芬芬 周喆峰 吴纯西 刘俊 

机构地区：[1]浙江省桐乡市第一人民医院麻醉科,桐乡314500

出　　处：《江西医药》2007年第4期292-294,共3页Jiangxi Medical Journal

摘　　要：目的研究在侧卧位胸科手术时纤支镜(FOB)引导下插入支气管阻断器(BB)行单肺通气(OLV)的可行性。方法40例开胸手术患者,随机分BB(A组)和双腔支气管(DLT,B组)两组,在麻醉诱导后,A组插入普通单腔气管导管(SLT),术中侧卧位下经FOB引导将BB放置于左或右主支气管,向BB套囊内注入4～6ml空气,阻断一侧主支气管行OLV。B组插入DLT,侧卧位FOB定位固定。结果40例患者插管均成功,OLV30min﹑60min时点A组患者动脉氧分压(PaO2)高于B组,气道压力(PAW)低于B组,差异有显著性(P<0.05)。结论侧卧位下经FOB引导插入BB应用在胸科手术OLV方法简便,损伤小,能维持良好的通气和氧和,没有因体位变动而导管移位的优点。Objective To study the possibility of OLV inserted by BB with FOB guiding in thoracil surgery of lateral position.Methods 40patients undergoing thoracil surgery were randomly assigned into bronchial blocker （A）group and double-lumen endobronchial tube （DLT, B）group.After anesthesia was induced,ln group A,intubate single-lumen endobronehial tube（SLT）and posit BB to left or right primary bronchus guided by FOB during surging of lateral position,inject 4-6ml air to BB balloon and block one lateral primary bronchus for OLV,In group B,intubate DLT with FOB and posit tube. Results 40patients＇intubations were all successful,in OLV timespot of 30min and 60min,patients＇PaO2 values in group A were higher than those in group B.These was signigicant difference between group A and group B（P〈0.05）.Conclusion The application of BB inset with FOB guiding in OLV during thoracil surging of lateral position with FOB guiding in OLV during thoracil surging of lateral position has advantage of convenience,slight harm.fine ventilation and oxygenation,no tubercular position.

关 键 词：纤支镜 支气管堵塞器 侧卧位插管 单肺通气 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]