单双肺气道压差值在双腔气管导管插管的定位效果观察  

Observation on the positioning effect of airway pressure differences between one lung and two lung ventilation in double-lumen tracheal intubation

作　　者：周会影 费昱达 权翔[1] Zhou Huiying;Fei Yuda;Quan Xiang(Department of Anaesthesiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院麻醉科,100730

出　　处：《北京医学》2023年第6期512-515,共4页Beijing Medical Journal

基　　金：中国医学科学院中央级公益性科研院所基本科研业务(2020-RW320-003)。

摘　　要：目的 探讨单双肺气道压差值(airway pressure differences between one lung and two lung ventilation,ΔP)指导双腔气管导管(double lumen tube,DLT)插管定位的效率及肺隔离效果。方法 选取2021年11月至2022年10月北京协和医院胸外科拟在单肺通气下手术的患者396例,患者随机分为纤维支气管镜(fiber optical bronchoscopy,FOB)组和ΔP组,每组198例,FOB组采用FOB定位DLT,ΔP组采用ΔP定位DLT。比较两组侧卧位后DLT调整时间、DLT插管时间、SpO_(2)及肺塌陷效果满意度。结果 396例患者中,男203例,女193例,年龄36~69岁,平均(56.8±4.8)岁。ΔP组侧卧位后DLT调整时间短于FOB组[(37.73±14.06)s比(51.76±15.74)s],差异有统计学意义(P<0.05);两组DLT插管时间、SpO_(2)、肺塌陷效果满意度的比较,差异均无统计学意义(P>0.05)。结论 ΔP具有操作时间短、较高DLT定位成功率和较好单肺通气肺塌陷效果等优势,尤其在FOB缺少时,ΔP可作为DLT插管定位的新方法。Objective To explore the positioning efficiency and lung isolation effect of double lumen tube(DLT) intubation guided by airway pressure differences between one lung and two lung ventilation(ΔP).Methods A total of 396patients in the Department of Thoracic Surgery of Peking Union Medical College Hospital from November 2021 to October 2022 were selected,and were randomly divided into the fiber optical bronchoscopy(FOB) group and ΔP group,with 198patients in each group.DLT was located by the method of FOB in FOB group,while DLT was located by ΔP in ΔP group.The DLT adjustment time,DLT intubation time,SpO_(2) and satisfaction of lung collapse effect were compared between the two groups.Results There were 203 males and 193 females among the 396 patients,aged from 36 to 69 years,with an average age of(56.8 ± 4.8)years.The DLT adjustment time in ΔP group was shorter than that in FOB group [(37.73 ± 14.06)s vs.(51.76 ± 15.74)s],and the difference was statistically significant(P<0.05).There were no significant differences in the intubation time,SpO_(2) and satisfaction of lung collapse effect between the two groups(all P>0.05).Conclusions ΔP method has the advantage of short operation time,higher positioning success rate of DLT and better lung collapse effect of one-lung ventilation,especially in the case of FOB shortage,which indicates that ΔP can be used as a new method for DLT intubation positioning.

关 键 词：双腔气管导管 气道压差 单肺通气 定位 

分 类 号：R614[医药卫生—麻醉学]