Arndt支气管内阻断器和双腔支气管导管在小儿单肺通气中的比较

发布时间：2018-03-25 17:02

本文选题：Arndt支气管内阻断器　切入点：双腔支气管导管　出处：《首都医科大学学报》2017年03期

【摘要】：目的比较Arndt支气管内阻断器和双腔支气管导管在小儿胸科手术中的单肺通气效果。方法将40例择期行胸科手术的患儿采用数字表法随机分为Arndt支气管内阻断器组(A组)和双腔支气管导管组(D组),每组20例。两组患儿在麻醉诱导后行Arndt支气管内阻断器或双腔支气管导管置入。观察记录两组患儿插管前(T_1)、插管时(T_2)、双肺通气时(T_3)、单肺通气时(T_4)平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、呼气末二氧化碳分压(end-tidal carbon dioxide partial pressure,Pet CO_2)及气道压力(airway pressure,Paw)变化。记录插管时间、肺萎陷时间、单肺通气时间、术中低氧情况以及不良事件发生情况。结果 Arndt支气管内阻断器组(A组)与双腔支气管导管组(D)比较,气道压力在单肺通气时(T_4),A组明显低于D组,呼气末二氧化碳分压在单肺通气时(T_4),A组明显低于D组(P0.05);A组患儿的插管定位时间短于D组(P0.05),肺完全萎陷时间、萎陷程度明显长于、优于D组(P0.05)。结论与盲插双腔支气管导管相比,纤支镜定位Arndt支气管内阻断器在小儿胸科手术中能提供更好的单肺通气效果。
[Abstract]:Objective to compare the effect of single lung ventilation between Arndt intra bronchial occluder and double lumen bronchial catheter in pediatric chest surgery. Methods 40 children undergoing elective thoracic surgery were randomly divided into Arndt intra bronchial occluder group by digital table method. Group A (n = 20) and group D (n = 20) were treated with Arndt intra bronchial occluder or double lumen bronchial catheterization after anesthesia induction. Mean arterial pressure MAPP, heart rate, heart rate, end-tidal carbon dioxide partial pressurePet CO2), airway pressure and airway pressure during one-lung ventilation. Results compared with double lumen bronchial catheter group (group A), airway pressure in group A was significantly lower than that in group D during single lung ventilation, and the incidence of hypoxia and adverse events in group A was significantly lower than that in group D during single lung ventilation, the results showed that the airway pressure in group A was significantly lower than that in group D (P < 0.05), and that in group A was significantly lower than that in group D (P < 0.05). The intubation localization time of group A was significantly lower than that of group D (P 0.05), and the time of complete lung collapse was longer than that of group D (P 0.05), which was better than that of group D (P 0.05). Conclusion compared with the blind insertion of double-lumen bronchial catheter, the time of complete lung collapse was significantly longer in group A than that in group D, and it was better than that in group D (P 0.05). Arndt endobronchial occluder with fiberoptic bronchoscope can provide better effect of single lung ventilation in pediatric chest surgery.
【作者单位】：首都医科大学附属北京儿童医院麻醉科;
【分类号】：R726.1

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