可视喉镜联合支气管封堵器与双腔支气管导管在胸科手术麻醉气管插管规范化培训教学中的应用  

Application of video laryngoscope combined with bronchial blocker and double-lumen tube in the standardized training of anesthesia for tracheal intubation

作　　者：段薇娜[1] 孔倩[1] 孙倩[1] 袁敏[1] 赵桂华 汪华新[1] 马莉 吴晓静[1] Duan Weina;Kong Qian;Sun Qian;Yuan Min;Zhao Guihua;Wang Huaxin;Ma Li;Wu Xiaojing(Department of Anesthesiology,Renmin Hospital,Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院麻醉科,武汉430060

出　　处：《中华医学教育探索杂志》2023年第1期124-127,共4页Chinese Journal of Medical Education Research

基　　金：国家自然科学基金(81901952);湖北省自然科学基金(2019CFB473);中央高校基本科研业务费专项基金(2042018kf0135)。

摘　　要：目的:探讨可视喉镜联合支气管封堵器与可视喉镜联合双腔支气管导管对麻醉专业住院医师规范化培训学员在胸外科气管插管教学中的应用。方法:将住院医师规范化培训的学员分为对照组和试验组进行临床教学,每组25人。试验组采用可视喉镜联合支气管封堵器,对照组采用可视喉镜联合双腔支气管导管。比较两组插管时间、纤支镜定位时间、插管即刻患者血流动力学变化程度、插管成功率、术后并发症发生率及学员考核成绩。采用GraphPad Prism 6.0软件进行t检验和卡方检验。结果:试验组学员气管插管时间[(95.3±10.1)vs.(137.5±13.5)]和定位时间[(100.8±11.7)vs.(155.4±15.3)]均短于对照组(P<0.001),试验组学员插管即刻患者血流动力学变化小(P<0.001)、插管成功率高(92%vs.68%)(P<0.001)、并发症低(P<0.001)、学员考核成绩高(P<0.001)。结论:胸外科手术麻醉教学中气管插管时应用支气管封堵器比双腔支气管导管更能缩短气管插管时间,降低患者插管时血流动力学变化,减轻并发症发生率,以及提高气管插管成功率和增强学员自信心。Objective To explore the comparative study of video laryngoscopy combined with bronchial blocker and video laryngoscopy combined with double-lumen tube in the teaching of endotracheal intubation in thoracic surgery in the standardized residency training of anesthesia.Methods The trainees of the standardized residency training were randomly divided into control group and experimental group for clinical teaching,with 25 ones in each group.The experimental group was treated with visual laryngoscopy combined with bronchial blocker,while the control group was treated with visual laryngoscopy combined with double-lumen tube group.The intubation time,intubation success rate,positioning time,hemodynamic changes,and complication incidence during intubation,as well as student assessment results were recorded.GraphPad Prism 6.0 was used for t test and Chi-square test.Results The time of endotracheal intubation[(95.3±10.1)vs.(137.5±13.5)]and positioning time[(100.8±11.7)vs.(155.4±15.3)]in the experimental group were both shorter than those of the control group(P<0.001),the hemodynamic changes in patients with immediate intubation were smaller(P<0.001),the success rate of intubation was higher(92%vs.68%)(P<0.001),the complication incidence was lower(P<0.001)and the students'performance was higher(P<0.001).Conclusion In the anesthesia teaching of thoracic surgery,bronchial blocker can reduce the time of endotracheal intubation,lower the hemodynamic changes during intubation,cut down the incidence of complications,improve the success rate of endotracheal intubation and enhance the confidence of students.

关 键 词：支气管封堵器 双腔支气管导管 气管插管 教学 

分 类 号：R614.2[医药卫生—麻醉学]