便携式纤维支气管镜法和听诊器法用于胸腔外科手术麻醉定位双腔气管插管的对比研究  

Comparison of portable fiber bronchoscope and stethoscope in positioning of the double lumen endotracheal intubation in thoracic surgery

作　　者：杨永慧[1] 郭瑜[1] 喻倩[1] 陶蕾[1] 丁倩[1] 

机构地区：[1]第四军医大学唐都医院麻醉科,西安市710038

出　　处：《实用医学杂志》2015年第21期3537-3539,共3页The Journal of Practical Medicine

摘　　要：目的：比较便携式纤维支气管镜法和听诊法用于胸腔外科手术麻醉定位双腔气管插管的效果。方法：选择连续入院ASAⅠ-Ⅲ级需行双腔气管插管的胸科择期手术患者,随机分为听诊（A）组和纤支镜（B）组,每组100例。所有患者全麻诱导后待睫毛反射消失、肌松监测TOF值为0、熵指数40-60之间时在可视喉镜下行双腔气管插管。记录患者调整气管插管位置前、后平均动脉压、心率、脉搏氧饱度、TOF值、熵指数、呼气末二氧化碳、双腔气管插管定位时间及正确率。结果：两组患者双腔气管插管定位时间A组较B组用时长,尤其右侧双腔气管插管定位时间,两组间差异有统计学意义（P〈0.05）。两组患者双腔气管插管准确率A组较B组低,尤其是行右侧双腔气管插管时,两组间差异有统计学意义（P〈0.05）。结论：便携式纤支镜法用于定位双腔气管插管快速便捷,准确率高,对患者循环系统影响小,值得临床推广应用。Objective To compare the effect of the portable fiber bronchoscope and stethoscope in positioning double lumen endotracheal intubation in the thoracic surgery. Methods Consecutive patients undergoing elective thoracic surgery of with double lumen endotraeheal intubation anesthesia, ASA Ⅰ - Ⅲ admission grade, 200 cases were randomly divided equally into stethoscopepositioning （group A） and portable fiber bronchoscope positioning （group B）. All of the patients were set double lumen endotracheal intubation by visual laryngoscope after anesthesia induction in eyelash areflexia, muscle relaxant monitoring TOF value is O, the entropy index between 40 and 60. Being recorded mean arterial pressure （MBP）, heart rate （HR）, pulse oxygen filling degree （SpO2）, TOF value, entropy index and PETCO2 before and after adjust the position of double lumen endotracheal intubation, double lumen endotracheal intubation positioning time and accuracy. Results Compring with the group B, the time was significantly longer in the group A in positioning double lumen endotracheal intubation, especially the positioning time in the right side of the double lumen endotracheal intubation （P 〈 0.05）. The accuracy was also significantly lower in positioning double lumen endotracheal intubation in group A, especially the right side of the double lumen endotracheal intubation （P 〈 0.05）. Conclusion It is not only easy and quickly, high accuracy with portable fiber bronchoscope positioning double lumen endotracheal intubation in thoracic surgery, but also less impact in the circulatory system of patients. It is worthy of clinical popularization and application.

关 键 词：便携式纤维支气管镜 听诊器 定位 双腔气管插管 

分 类 号：R614[医药卫生—麻醉学]