Univent管与双腔支气管导管实现单肺通气的安全性比较  

Comparison of safety between double lumen-tube and univent tube for single-lung ventilation

作　　者：何旭东[1] 杨勇[1] 段佐平[1] 范文江[1] 易明亮[1] 颜渊[1] 

机构地区：[1]内江市第一人民医院麻醉科,普外科,四川内江641000

出　　处：《四川医学》2009年第3期354-356,共3页Sichuan Medical Journal

摘　　要：目的比较应用双腔支气管导管及Univent管行单肺通气的安全性,及对术后声音嘶哑、咽喉痛的影响。方法选择需单肺通气择期行食管癌根治术的患者100例。随机分为Univent管组和双腔支气管组,每组50例。Univent管组通过插Univent管实现单肺通气,双腔支气管组通过插入双腔支气管导管实现单肺通气。所有气管插管均由同一个熟练的麻醉医生完成。主要观察指标:①完成插管所用时间;②单肺通气时肺萎陷质量和外科术野暴露程度;③治疗后24、48、72h采用标准化问题对声音嘶哑和咽喉痛进行评估。结果①双腔支气管组的插管时间明显较Univent管组长(P<0.05);②单肺通气时肺萎陷质量和外科术野暴露程度在两组间差异均无统计学意义(P>0.05);③双腔支气管组术后声音嘶哑及咽喉疼痛的发生率较Univent管组显著升高(P<0.05)。两组患者均未发生如支气管断裂等严重并发症。结论双腔支气管导管和Univent管在食管癌根治术患者行单肺通气中的应用均安全有效,应用Univent管可减少患者术后声音嘶哑及咽喉疼痛的发生率,在适应证范围内可以首先选用Univent管。Objective To compare the safety and impact on the incidence and severity of postoperative hoarseness and sore throat between double lumen-tube and univent tube for single-lung ventilation. Methods 100 patients who underwent resection of esophageal cancer by single-lung ventilation were randonfly divided into univent tube and double lumen-tube groups（ n = 50）. Ali patients were subjected to single-lung ventilation by univent tube or double lumen-tube, respectively. The tracheal intubation was performed by the same anesthetist. Main outcome measures： （1）The time for intubation; （2）Atelectasis and exposure extent in surgery at single-lung ventilation;（3）Postoperative hoarseness and sore throat were assessed at 24,48 and 72 hours. Results The time for intubation in double lmnen-tube group was longer than univent tube group（ P 〈 0.05 ） . There were no significant differences in mean arterial blood pressure and basic vital sign before and after intubation between two groups（ P 〉 0.05 ） . There were no significant differences in atelectasis and exposure extent in surgery betv, een two groups（ P 〉 0.05 ） . Postoperative hoarseness occurred significantly more frequently in the double- lumen group than in the univent tube group（ P 〈 0.05） . No major complications such as bronchial ruptures were observed in both groups. Conclusion Single-lung ventilation can be achieved via either a double lumen, tube or an univent tube. However, univent tube is recommended for single-lung ventilation because it can reduce the incidence of vocal cord injuries, postoperative hoarseness and sore throat.

关 键 词：双腔支气管导管 UNIVENT管 声音嘶哑 咽喉痛 

分 类 号：R614[医药卫生—麻醉学]