循序渐退法行左侧双腔支气管插管的临床研究  

Clinical study on gradual withdrawal method with left-sided double-lumen endobronchial tube for tracheal intubation

作　　者：颜勇军[1] 郑珈琳 钟庆[2] 汪辉德[2] 陈涛[2] 邬瑞刚 陈光忠[2] 

机构地区：[1]四川省安岳县人民医院麻醉科,四川安岳642350 [2]四川省简阳市人民医院麻醉科,四川简阳641400

出　　处：《实用医院临床杂志》2011年第5期60-62,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨循序渐退法用于左侧双腔支气管导管(left-sided double lumen endobronchial Tube,L-DLT)插管及纤维支气管镜(fiberoptic bronchoscope,FOB)辅助插入深度的定位。方法 80例实施择期开胸和胸腔镜手术的全麻患者采用计算机随机法分为传统听诊法组(A组)和循序渐退法组(W组)各40例。均采用静脉麻醉诱导,待患者意识丧失肌肉松弛后行L-DLT操作。W组采用循序渐退法行左侧双腔支气管插管;A组按传统听诊法定位。观察定位时间、FOB检查置管深度、实际到位率以及气管插管相关并发症。结果定位时间两组差异无统计学意义(P>0.05),置管深度和实际到位率A组均明显优于W组(P<0.05)。经FOB检查,A组错位原因中插入过深最主要,且明显多于W组(P<0.05)。结论 循序渐退法用于左侧双腔支气管插管,能够显著提高正确到位率。Objective This study aimed to investigative gradual withdrawal method on tracheal intubation by left-sided double-lumen endobronchial tube（L-DLT） and positioning of the depth of penetration fiberoptic bronchoscope（FOB）.Methods Eighty adult patients who scheduled for video-assisted or/and thoracic surgery were randomly assigned to group A（n=40） using traditional auscultation method and group W（n=40） using gradual withdrawal method for tracheal intubation.After standard intravenous anesthetic induction,insertion of L-DLT was performed.In group W,gradual withdrawal method was used to insert L-DLT.In group A,traditional auscultation method was used to position.The time of positioning,depth of intubation,cases of ideal anatomic placement and incidence of complications were recorded.Results There were no statistical significance in the time of trachea intubation（P0.05）.The depth of intubation in group A was deeper than that of group W,but cases of ideal anatomic placement was less than that of group W（P0.05）.Over insertion of L-DLT,which was the main reasons of inappropriate location of intubation,in group A was more than that in group W（P0.05）.Conclusions Compared with traditional auscultation method,gradual withdrawal method can effectively and safely improve the rate of correct ideal anatomic placement of L-DLT.

关 键 词：双腔支气管导管 纤维支气管镜 开胸手术 

分 类 号：R614.24[医药卫生—麻醉学] R616.5[医药卫生—外科学]