改良可视双腔支气管导管塑形方法在胸科手术单肺通气中的应用  

Application of modified visual double-lumen tube molding method in one-lung ventilation in thoracic surgery

作　　者：解凤磊 李梦华 冯迎迎 葛晓燕[1] 闫声明 宋小倩 何川[1] 吴浩 XIE Fenglei;LI Menghua;FENG Yingying;GE Xiaoyan;YAN Shengming;SONG Xiaoqian;HE Chuan;WU Hao(Department of Anesthesiology of Bozhou People's Hospital,Bozhou 236800,China;Department of Anesthesiology of Suqian First People's Hospital,Suqian 223800,China)

机构地区：[1]亳州市人民医院麻醉科,安徽亳州236800 [2]宿迁市第一人民医院麻醉科,江苏宿迁223800

出　　处：《中华灾害救援医学》2022年第2期75-78,93,共5页Chinese Journal of Disaster Medicine

基　　金：亳州市人民医院重点三新项目(2021ZDB-01)。

摘　　要：目的观察改良可视双腔支气管导管(Visual Double-Lumen Tube,VDLT)塑形方法在胸外科手术单肺通气中的应用效果。方法选取2020-08至2021-08我院胸外科择期手术单肺通气患者60例,美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级I~Ⅲ级,年龄24~80岁,性别不限,BMI 19~28 kg/m2。采用随机数字表法将患者分为传统塑形组(Tsaditional Shaping,TS组)和改良塑形组(Isproved Shaping,IS组),每组30例。记录麻醉诱导前(T1)、麻醉诱导后即刻(T2)、插管后1 min(T3)的心率(Heart Rate,HR)及平均动脉血压(Mean Arterial Pressure,MAP);记录插管时间、插管次数、支气管定位情况;记录术后咽喉部疼痛、声音嘶哑等并发症情况。结果 TS组插管时间(67.1±23.8)s明显长于IS组(38.9±10.0)s;TS组插管次数1.3±0.4次明显多于IS组1.0±0.0次(P<0.05),两组可视双腔支气管导管支气管定位情况差异无统计学意义;与TS组比较,IS组T3时HR、MAP明显更低(P<0.05);与TS组比较,IS组术后咽喉部疼痛发生率及总并发症发生率更低(P<0.05),两组患者术后声音嘶哑发生率差异无统计学意义。结论改良VDLT塑形方法可缩短插管时间、降低插管难度、且不影响支气管定位,同时插管后患者的生命体征更平稳、术后并发症发生率低。Objective To observe the application effect of modified visual double-lumen tube(VDLT) shaping method in one lung ventilation(OLV) in thoracic surgery. Methods Sixty patients with elective OLV in the thoracic surgery department of our hospital were selected from August 2020 to August 2021, ASA grade I~Ⅲ, age 24 to 80 years old, gender unlimited, BMI 19 to 28 kg/m2. Patients were divided into traditional plastic group(TS group) and improved plastic group(IS group) by randomly, each with 30. Heart Rate(HR)and Mean Arterial Pressure(MAP) were recorded before anesthesia induction(T1), immediately after anesthesia induction(T2), and 1 min after intubation(T3). Intubation time, intubation times and bronchus location were recorded. Postoperative throat pain, hoarseness and other complications were recorded. Results The intubation time of TS group(67.1±23.8) s is longer than that of IS group(38.9±10.0) s. The intubation times of IS group(1.3±0.4) times are more than that of TS group(1.0±0.0) times(P<0.05). There was no significant difference in the bronchus location of the VDLT between the two groups. Compared with TS group, HR and MAP at T3 in IS group were significantly lower(P<0.05). Compared with TS group, the incidence of postoperative throat pain and total complications in IS group were lower(P<0.05),and there was no statistical significance in the incidence of postoperative hoarseness between the two groups. Conclusion The modified VDLT molding method can shorten the intubation time, reduce the difficulty of intubation, and does not affect the bronchus location. At the same time, the patient’s vital signs are more stable after intubation, and the incidence of postoperative complications is low.

关 键 词：改良塑形方法 传统塑形方法 可视双腔支气管导管 胸科手术 单肺通气 

分 类 号：R164.2[医药卫生—公共卫生与预防医学]