支气管封堵器与双腔支气管导管用于食管癌根治术病人单肺通气效果的比较  

Comparison of bronchial blocker and double-lumen tube for one-lung ventilation in patients undergoing esophageal cancer resection

作　　者：杨禄坤[1] 梁军[2] 苏永辉[3] 肖笑雨[1] 范东毅[1] 周少朋[1] 

机构地区：[1]519000珠海市,中山大学附属第五医院麻醉科 [2]519000珠海市,中山大学附属第五医院麻醉科口腔颌面外科 [3]519000珠海市,中山大学附属第五医院麻醉科普外科

出　　处：《中华麻醉学杂志》2013年第9期1099-1101,共3页Chinese Journal of Anesthesiology

摘　　要：目的 比较支气管封堵器与双腔支气管导管用于食管癌根治术病人单肺通气的效果.方法 择期行食管癌根治术的病人40例,性别不限,年龄42 ～ 63岁,ASA分级Ⅰ～Ⅲ级,采用随机数字表法,将其分为2组（n=30）：双腔支气管导管组（DLT组）和支气管封堵器组（BB组）.麻醉诱导后,DLT组经口插入左侧双腔支气管导管,随后用纤维支气管镜调整导管的位置.BB组先经口插入单腔气管导管,随后在纤维支气管镜的引导下插入支气管封堵器.记录插管时间、单肺通气时间、肺萎陷时间、手术时间、拔管时间、导管移位和低氧血症的发生情况；术毕行肺萎陷评分；记录气管拔管后2d内声嘶、喉痛的发生情况和术后7d内肺部感染的发生情况.结果 与DLT组比较,BB组插管时间和肺萎陷时间延长,术后声嘶和喉痛发生率降低（P＜0.05）,单肺通气时间、手术时间、拔管时间、肺萎陷评分、导管移位、低氧血症和术后肺部感染的发生率差异无统计学意义（P＞0.05）.结论 支气管封堵器用于食管癌根治术病人单肺通气的效果与双腔支气管导管相似.Objective To compare the bronchial blocker and double-lumen tube for one-lung ventilation in patients undergoing esophageal cancer resection.Methods Forty ASA physical status Ⅰ-Ⅲ patients of both sexes,aged 42-63 yr,scheduled for elective esophageal cancer resection,were randomly divided into 2 groups （n =20 each）：double-lumen endotracheal tube group （group DLT） and bronchial blocker group （group BB）.After induction of anesthesia,the patients were intubated with a left-sided double-lumen endotracheal tube and correct positioning was verified by fiberoptic bronchoscopy in group DLT.After induction of anesthesia,the patients were intubated with a conventional single-lumen endotracheal tube,and then the bronchial blocker was inserted under the guidance of fiberoptic bronchoscope in group BB.The intubation time,one-lung ventilation time,time to achieve lung collapse,operation time,extubation time,tube malposition and hypoxemia were recorded.The lung collapse was scored at the end of operation.Hoarseness and throat sore within 2 days after extubation and pulmonary infections within 7 days after operation were recorded.Results Compared with group DLT,intubation time and time to achieve lung collapse were significantly prolonged,and the incidence of hoarseness and throat sore within 2 days after extubation was decreased in group BB （P 〈 0.05）.There was no significant difference in the one-lung ventilation time,operation time,extubation time,lung collapse score,incidence of tube malposition,hypoxemia and pulmonary infections within 7 days after operation between the two groups （P 〉 0.05）.Conclusion The efficacy of bronchial blocker is similar to that of double-lumen tube when used for one-lung ventilation in patients undergoing esophageal cancer resection.

关 键 词：呼吸 人工 食管肿瘤 

分 类 号：R614[医药卫生—麻醉学]