支气管封堵器用于右侧胸腔镜手术单肺通气的临床研究  

Clinical Observation of Bronchial Blocker for One Lung Ventlation during Right-sided Video-assisted Thoracic Surgery

作　　者：胡渤[1] 李照菊[1] 邵伟栋[1] 周巧梅[1] 杨瑞瑜[1] 屠伟峰[1] 

机构地区：[1]广州军区广州总医院麻醉科,广东广州510010

出　　处：《华南国防医学杂志》2015年第11期817-820,共4页Military Medical Journal of South China

基　　金：全军医学科技青年培育项目(13QNP052)

摘　　要：目的观察支气管封堵器（bronchial blockers,BB）用于右侧胸腔镜手术单肺通气的有效性、安全性和舒适性。方法择期行右侧胸腔镜手术ASAⅠⅢ级患者62例,随机分为双腔支气管导管（double lumen tubes,DLT）组（n=32）和BB组（n=32）,两组均采用视频喉镜插管并利用纤维支气管镜定位,记录插管定位时间（Tint）、肺萎陷时间（Tcol）和肺萎陷满意率、记录侧卧位后和单肺通气期间的导管移位率（Malposition）和应用PEE情况,记录拔管后躁动和术后第1天和第2天咽痛和声嘶的发生率。结果两组患者的肺萎陷满意率无明显差异。BB组的插管时间和肺萎陷时间显著长于DLT组。BB组侧卧位后的导管移位率高于DLT组。DLT组躁动、术后第1天咽痛和术后第2天声嘶的发生率均高于BB组。结论在严密监护下,支气管封堵器可以较安全、有效的实施右侧胸腔镜手术的单肺通气,且舒适性较高。Objective To observe the efficacy, safety and comfort of bronchial blocker for one lung ventilation dur- ing right-sided video-assisted thoracic surgery, and compare with left-sided double lumen tube （DLT）.Methods Sixty-two eligible patients scheduled for right-sided video-assisted thoracic surgery enrolled and were randomly allocated to group DLT （n = 32） and group bronchial blockers （BB） （n = 32）. Intubation and lung collapsed time were recorded. Quality of lung collapse were evaluated by surgeon.The incidence of malposition rates from the sapine position during turning to the lateral position and during one lung ventilation were recorded. Agitation during extubation and postoperative throat pain and hoarseness were assessed. Results Quality of collapse evaluated by the surgeon were not significantly different be- tween two groups.Intubation time （99s vs 90s） and collapsed time （89s vs 79s） were significantly longer in BB group than those in group DLT （P〈0.05）.The malposition rates from the supine position turning to the lateral position were significantly higher in BB group （P 〈0,05）. The incidence of agitation during extubation and throat pain 1 day after operation and hoarseness 2 day after operation were higher in group DLT （P〈0.05）.Conclusion BB can be applied for one lung ventila- tion during right-sided video-assisted thoracic surgery efficaciously and safely and it＇s more uncomfortable than DLT.

关 键 词：支气管封堵器 双腔支气管导管 单肺通气 胸腔镜手术 

分 类 号：R735.1[医药卫生—肿瘤]