可视软镜引导硅胶双腔管与聚氯乙烯双腔管在肥胖患者气管插管中的比较  

Comparison of silicone double-lumen tube and polyvinyl chloride double cavity tube guided by flexible visual endoscope in endotracheal intubation in obese patients

作　　者：解凤磊 刘伟[1] 王杰杰 李梦华 费利娟 邱涛 李元海[2] XIE Fenglei;LIU Wei;WANG Jiejie;LI Menghua;FEI Lijuan;QIU Tao;LI Yuanhai(Department of Anesthesiology,the People's Hospital of Bozhou,Bozhou 236800,China)

机构地区：[1]安徽省亳州市人民医院麻醉科,236800 [2]安徽医科大学第一附属医院麻醉科

出　　处：《临床麻醉学杂志》2025年第2期130-134,共5页Journal of Clinical Anesthesiology

基　　金：亳州市人民医院三新项目(2022YB-14);亳州市人民医院科研项目库项目(by2022053)。

摘　　要：目的比较可视软镜引导硅胶双腔管和预热聚氯乙烯双腔管在肥胖患者气管插管中的效果。方法选择择期行单肺通气手术患者79例,男36例,女43例,年龄25~64岁,BMI 28.0~35.0 kg/m^(2),ASAⅠ—Ⅲ级。采用随机数字表法将患者分为两组:硅胶双腔管组(SD组,n=40)和聚氯乙烯双腔管组(PH组,n=39)。SD组采用硅胶双腔管,使用前放置于常温中。PH组采用聚氯乙烯双腔管,使用前将双腔管放置于50℃恒温箱中预热20 min。两组均选择左侧型双腔管。记录声门暴露时间、气管插管时间、双腔管置管阻力分级、置管次数。记录首次置管成功、低氧血症、支气管错位例数、可视喉镜使用情况。记录气管损伤、术后声音嘶哑、咽喉疼痛等并发症情况。结果与PH组比较,SD组气管插管时间明显缩短(P<0.05),双腔管置管阻力明显减小(P<0.05),置管次数明显减少(P<0.05),首次置管成功率明显升高(P<0.05),低氧血症发生率、可视喉镜使用率、气管损伤、术后声音嘶哑、咽喉部疼痛发生率、术后咽喉疼痛评分明显降低(P<0.05)。两组声门暴露时间和支气管错位率差异无统计学意义。结论肥胖患者采用可视软镜引导硅胶双腔管行气管插管安全、有效,与引导预热聚氯乙烯双腔管比较,采用硅胶双腔管气管插管时间更短,置管次数更少、阻力更小,气管损伤和术后并发症发生率更低。Objective To observe the effect of silicone double-lumen tube and preheated polyvinyl chloride double-lumen tube guided by flexible visual endoscope in endotracheal intubation in obese patients received elective thoracic surgery.Methods Seventy-nine patients received elective thoracic surgery,36 males and 43 females,aged 25-64 years,BMI 28.0-35.0 kg/m^(2),ASA physical statusⅠ-Ⅲ,were selected.They were randomly divided into two groups:silicone double-lumen tube group(group SD,n=40)and polyvinyl chloride double-lumen tube group(group PH,n=39).Group SD used silicone double-lumen tubes,which were placed at room temperature before use.Group PH used polyvinyl chloride double-lumen tube,which were placed in a 50℃constant temperature box for preheating for 20 minutes before use.Both groups selected left-side double-lumen tube.The time of glottis exposure by the video soft endoscope,tracheal intubation time,double-lumen tube placement resistance grade,and number of placements were recorded.The incidence of first placement success,hypoxemia,bronchial dislocation,and video laryngoscope usage were recorded.Complications such as airway injury,postoperative sore throat,and hoarseness were recorded.Results Compared with group PH,group SD had significantly shorter intubation time,significantly reduced double-lumen tube insertion resistance(P<0.05),significantly reduced intubation times(P<0.05),significantly increased first-time intubation success rate(P<0.05),and significantly reduced the incidence of hypoxemia,use rate of video laryngoscope,incidence of complications of tracheal injury,postoperative hoarseness,sore throat,and postoperative sore throat score(P<0.05).There was no significant difference in the time of glottis exposure and bronchial dislocation rate between the two groups.Conclusion Silicone double-lumen tube and preheated polyvinyl chloride double-lumen tube are safe and effective for endotracheal intubation in obese patients.The use of silicone double-lumen tube for endo￣tracheal intubation takes less tim

关 键 词：硅胶双腔管 聚氯乙烯双腔管 预热 可视软镜 肥胖 

分 类 号：R614[医药卫生—麻醉学]