纤维支气管镜判断三种方法联合应用于双腔支气管导管就位的准确率  

Positioning of double lumen endobronchial tube by three combined ethods with fibroptic bronchoscope

作　　者：王庆亮[1,2] 赵砚丽[1] 刘晓明[1] 

机构地区：[1]河北省人民医院麻醉科,050051 [2]青岛市胶州中心医院麻醉科

出　　处：《临床麻醉学杂志》2010年第12期1059-1060,共2页Journal of Clinical Anesthesiology

基　　金：河北省科技计划资助项目(10276105D-5)

摘　　要：目的以纤维支气管镜(FOB)判断联合应用听诊法、气道压力变化法及PETCO2波形法在双腔支气管导管(DLT)就位的准确率。方法选择胸科麻醉手术患者60例,静脉诱导后插入RobertshawDLT。通过三种方法联合应用调整导管位置达到标准后用FOB判断RobertshawDLT就位的准确率。结果平卧位时,DLT就位满意率为95%;侧卧位后,DLT就位满意率为93.4%。结论三种方法联合应用明显提高DLT就位满意率,但FOB仍是确定DLT位置的金标准。Objective To observe the correctly positioning rate of left-sided double lumen endobronchial tube by combined adjustment of auscultation,PETCO2 and airway pressure changes.Methods Sixty adult patients undergoing thoracic surgery were intubated with Robertshaw DLTs. DLT position is checked and adjusted by fiberoptic bronchoscope（FOB）. Results In the supine position,successful intubation is 57 cases by three combined methods,one of cases is shallower,two of cases are deeper,satisfactory rate is 95 percents;In the lateral decubitus position,successful intobution is 56 cases by three combined methods,two of cases is shallower,two of cases are deeper,satisfactory rate is 93.4 percents.Conclusion Three combined methods that are simple,reliable can be used repeatedly during postural changes without increasing the opportunities for injury,it is clinically a very good approach,but the absolute scope of safety is very small,FOB is necessary for positioning.

关 键 词：听诊 PETCO2 吸气峰压 双腔支气管导管 纤维支气管镜 

分 类 号：R614[医药卫生—麻醉学]