左侧双腔支气管插管支气管气囊测压法在择期胸科手术定位中的应用  

Application of left double-lumen bronchial intubation and bronchial balloon manometry in selective thoracic surgery localization

作　　者：张祖江 杨升宝 孙洪喜 Zhang Zujiang;Yang Shengbao;Sun Hongxi(Jiaozhou People's Hospital,Jiaozhou 266300,China)

机构地区：[1]胶州市人民医院,266300

出　　处：《国际医药卫生导报》2020年第9期1272-1275,共4页International Medicine and Health Guidance News

摘　　要：目的探究与分析左侧双腔支气管插管支气管气囊测压法在胸科手术定位中的应用。方法选取本院自2017年6月至2019年6月收治的90例于全麻下接受择期胸科手术的患者,采取随机数字表法分为球囊组与听诊组,每组45例。麻醉诱导成功满足插管条件后给予左侧双腔支气管插管,球囊组给予气囊测压法定位,听诊组给予传统听诊法定位,对比两组双腔支气管导管插管结果、定位时间、定位满意、各个时间点通气指标变化及并发症发生率。结果球囊组与听诊组相比,初次肺分隔成功率较高、一次插管位置准确率较高、插管位置过深及过浅率较低,定位时间较短,差异均有统计学意义(均P<0.05)。球囊组与听诊组相比,单肺通气时间、手术时间均无统计学差异(均P>0.05)。听诊组与球囊组麻醉前和单肺通气5 min、10 min、30 min、60 min、120 min时的SpO2、PETCO2、Paw各值相比,差异均无统计学意义(均P>0.05)。听诊组并发症总发生率为13.33%,球囊组为11.11%,听诊组与球囊组并发症发生率相比,差异无统计学意义(P>0.05)。结论左侧支气管气囊测压法相比于传统听诊法具有更高的定位成功率,操作简便,可以获得相同的通气氧合效果,并发症发生率较低,安全性高。Objective To explore and analyze the application of left-side double-lumen bronchial intubation and bronchial balloon manometry in localization.Methods Ninety patients who underwent selective thoracic surgery under general anesthesia were selected in our hospital from June 2017 to June 2019.All the patients were divided into a balloon group and an auscultation group with the random number table,45 patients in each group.After the anesthesia induction successfully met the intubation conditions,the left double-lumen bronchial intubation was implemented.The balloon group was given the balloon manometry localization method,while the auscultation group was given the traditional auscultation localization method.The double-lumen bronchial intubation results,positioning time,satisfactory positioning,changes in ventilation index at each time point,and complication rate were compared between the two groups.Results Compared with the auscultation group,the balloon group had a higher success rate of primary lung separation,a higher accuracy of localization of the first intubation,a lower rate of unfitted intubation,and shorter positioning time,with statistically significant differences(all P<0.05).There were no statistically significant differences in one-lung ventilation time and operation time between the balloon group and the auscultation group(all P>0.05).There were no statistically significant differences in the values of SpO2,PETCO2,and Paw between the auscultation group and the balloon group before anesthesia,one-lung ventilation for 5 min,10 min,30 min,60 min,120 min(all P>0.05).The complication rate in the auscultation group was 13.33%,and the complication rate in the balloon group was 11.11%,there was no statistically significant difference between the auscultation group and the balloon group(P>0.05).Conclusion Compared with the traditional auscultation method,the left bronchial balloon manometry has a higher localization success rate,which is easy to operate,and can obtain the same ventilation and oxygenation effec

关 键 词：左侧双腔支气管插管 气囊测压法 传统听诊法 定位 胸科手术 

分 类 号：R655[医药卫生—外科学]