支气管阻塞管在婴幼儿单肺通气中的应用  

Usage of endobronchial blocker in infant for one-lung ventilation

作　　者：肖婷[1] 颜璐璐[1] 裴冬杰[1] 屈双权[1] Xiao Ting;Yan Lulu;Pei Dongjie;Qu Shuangquan(Department of Anesthesiology, Hunan Children＇s Hospital, Changsha 410007, China)

机构地区：[1]湖南省儿童医院麻醉科,长沙410007

出　　处：《国际麻醉学与复苏杂志》2018年第5期431-433,共3页International Journal of Anesthesiology and Resuscitation

基　　金：湖南省卫生和计划生育委员会科研课题项目（B2015-124）

摘　　要：目的 评估5F Arndt支气管阻塞管在婴幼儿单腔气管导管外单肺通气（one-lung ventilation, OLV）的可行性和安全性。 方法 回顾性分析2岁以内需OLV的胸科手术患儿22例。所有患儿均在Cook导丝引导下置入5F Arndt支气管阻塞管，再置入小于标准型号0.5F气管导管，通过阻塞管的转化接头连接麻醉机维持通气的同时，在纤维支气管镜明视下定位阻塞管到目标支气管，分析支气管阻塞管移位例数、OLV前后气道压、肺萎陷的程度来评价支气管阻塞管的效果。 结果 22例患儿，年龄4个月~2岁，体重5.6~11.0 kg，20例患儿获得满意的单肺隔离。1例患儿OLV后SpO2下降。2例患儿术中出现支气管阻塞管移位，OLV后气道压力明显增高（P〈0.05）。 结论 Arndt支气管阻塞管可用于婴幼儿OLV肺隔离，但存在移位安全隐患。Objective Our goal was to investigate feasibility and safety of placing extraluminal 5F Arndt Endobronchial Blocker （AEB） guided by Cook guide-wire for thoracic surgery in infants. Methods We retrospectively examined the anesthetic records for details of AEB placement and evaluated the effect of lung isolation in 22 children under the age of 2 years undergoing OLV with a 5F AEB for thoracic surgery at our department. All the patients firstly had the AEB placed into the trachea with the Cook guide-wire, followed by the intubation of a cuffed Endotracheal tube （ETT） 0.5F size below the size expected for the age. The position of the AEB was adjusted with using ideo-assisted flexible fiber optic bronchoscope through the Arndt multi-port airway adaptor while the patients were ventilated. Results Twenty-two cases were included, aged from 4 months to 2 year old, weighted from 5.6 kg to 11.0 kg. We were able to successfully achieve lung isolation in 20 of 22 patients using a 5F AEB, 2 cases had AEB migrated and one case had hypoxia after one lung ventilation. Conclusions Extraluminal 5F AEB can be applied for thoracic surgery in young children, but there is a danger of migration.

关 键 词：单肺通气 婴幼儿 支气管阻塞管 

分 类 号：R726.1[医药卫生—儿科]