单腔气管导管在肥胖患者单肺通气中的探究  

The inquiry of the single lumen endotracheal tube during one lung ventilation

作　　者：高学超 闫小强 安静 刘钟珊 

机构地区：[1]开封市中心医院麻醉科,河南开封475000

出　　处：《河南大学学报（医学版）》2017年第3期212-215,共4页Journal of Henan University:Medical Science

摘　　要：[目的]探讨单腔气管导管在肥胖患者单肺通气中的可行性。[方法]60例择期例行右侧胸科手术患者,体重指数25~50,随机分为单腔气管导管组(Ⅰ组)和双腔支气管导管组(Ⅱ组)。Ⅰ组通过单腔气管导管实现单肺通气,Ⅱ组通过插入双腔支气管导管实现单肺通气。观察两组插管时血流动力学变化,插管时间、定位时间、气道峰压、外科术野暴露程度、胸膜打开后40分钟血气分析、术中吸引分泌物时间,拔管后用纤支镜观察声带损伤情况和声音嘶哑情况,随访肺不张,肺部感染和住院天数。[结果]Ⅰ组插管时间、声音嘶哑和声带损伤发生率,明显短于Ⅱ组(P<0.05)。Ⅰ组术中吸引分泌物时间大于Ⅱ组(P<0.05)。两组定位时间、气道峰压,外科术野暴露程度,血气分析,术后并发症和住院时间差异无统计学意义。[结论]单腔气管导管和双腔支气管导管均能应用胸科手术单肺通气中,在肥胖患者中应用单腔气管插管可缩短插管时间及减少患者术后声带损伤和声音嘶哑的发生。[Objective]To explore the feasibility of single lumen endotracheal tube for one lung ventilation. [Methods] sixty patients undergoing right thoracic surgery were randomized dividedinto two groups , group I received single lumen endotracheal tube and group II received double-lumen bronchial tube. Hemodynamic changes during intubation , the time of intubation and tube localization were recorded. Surgical satisfaction, airway pressures , the arterial blood gases 40min after pleural opening, the time of suction secretions , postoperative hoarseness were assessed at 24 and vocal cord lesions were examined by bronchoscopy immediately after surgery In the two groups. Follow up of pulmonary atelectasis, pulmonary infection and hospitalization days. [Results] Compared with group H, the time of intubation and tube localization was shorter in the group （P 〈 0.05） . Postoperative occurred of hoarseness and vocal cord lesions was lower in the group I （P 〈 0.05）. There were no significant diffefences in surgical satisfaction, pulmonary atelectasis, pulmonary infection and hospitalization days between the two groups. [Conclusion] One-lung ventilation can be achieved via single lumen endotracheal tube or double-lumen bronchial tube . However, The application of single lumen endotracheal tube can shorten the time of intubation and localization and reduced the incidence of vocal cord injuries, postoperative hoarseness.

关 键 词：单肺通气 单腔气管导管 双腔支气管导管 

分 类 号：R614.2[医药卫生—麻醉学]