颈托可减少左侧开胸手术患者体位变动后的右侧双腔气管导管错位  

Use of a cervical gear minimizes right-double-lumen tube displacement during patient positioning

作　　者：苗玉良[1] 时文珠[2] 张永强[2] 谷茂林 刘骥[1] 刘艳[1] 吕砚[1] 汪江[1] 方伟武[1] 

机构地区：[1]解放军第306医院麻醉科,北京100101 [2]解放军总医院麻醉手术中心,北京100853

出　　处：《临床军医杂志》2014年第11期1156-1158,1171,共4页Clinical Journal of Medical Officers

摘　　要：目的探讨用颈托限制患者颈部和头部移动,防止右双腔管错位的价值。方法将择期行左侧开胸手术的60例患者,随机分为对照组和颈托组。均使用右双腔管插管,颈托组在气管插管前戴好颈托。在仰卧位和侧卧位,用纤支镜分别测定主气管导管开口到主隆凸以及支气管开口到支气管隆凸的距离,对比患者体位变动对导管错位的影响。结果仰卧位改为侧卧位后,对照组的主气管导管和右支气管导管的错位均大于颈托组(5.9±1.7 mm比对2.1±0.9 mm,2.3±0.8mm比对1.1±0.7 mm,P<0.01)。从正确位置移位>5 mm的发生率,对照组大于颈托组(47%比对17%,P<0.01)。结论左侧开胸术行右双腔管插管麻醉中使用颈托限制头颈活动,可以减少右双腔管位移。Objective To investigate whether the cervical gear could reduce the displacement of the right-double-lumen tube （RDLT） when the patients were changed to right lateral position. Methods Sixty patients were divided into control group and cervical gear group. In the supine and the right lateral position, the distance from the opening of the tracheal lumen to the main carina and that from the distal tip of the bronchial lumen to the right bronchial carina were measured. Results Displacement of the RDLT during a change from the supine to the lateral decubitus position was greater in the control group than in the brace group （ P 〈 0.01 ）. The incidence of clinically significant displacement, greater than 5 mm from the initial correct position, was higher in the control group than in the brace group （P 〈 0.01 ）. Conclusion By restricting head and neck movements with a cervical gear, the RDLT displacement may be reduced while positioning patients for thoracotomy.

关 键 词：右侧双腔管 体位 移位 错位 

分 类 号：R655[医药卫生—外科学]