可视双腔支气管导管用于胸科手术的安全性和有效性评价

发布时间：2018-05-23 21:56

本文选题：胸科手术 + 可视双腔支气管导管　；参考：《华中科技大学学报(医学版)》2017年04期

【摘要】：目的探讨可视双腔支气管导管(double-lumen bronchial tube,DLT)应用于胸科手术的安全性和有效性。方法选择在华中科技大学同济医学院附属同济医院行择期胸科手术患者80例,随机分为对照组(普通左侧RobertshawDLT)和实验组(可视左侧Robertshaw-DLT)。静脉麻醉诱导后分别置入DLT,对照组通过听诊法定位,实验组通过导管内置摄像头定位。待定位完成后行纤维支气管镜检查,记录插管后的血流动力学变化、插管用时、定位准确率;记录气管隆突及支气管损伤情况;记录术中肺萎陷情况;记录术后咽痛、声嘶等发生率。结果与对照组相比,插管后实验组患者平均动脉压(MAP)及心率(HR)明显低于对照组(均P0.05),实验组插管定位用时显著缩短(P0.05)、准确率显著提高(P0.05);气管隆突或支气管黏膜损伤明显减少(均P0.05);术后咽痛、声嘶发生率显著降低(均P0.05)。结论可视双腔支气管导管可安全用于胸科手术,定位精准快速,并发症少,值得临床推广。
[Abstract]:Objective to evaluate the safety and efficacy of double-lumen bronchial tube-DLTs in thoracic surgery. Methods Eighty patients with elective thoracic surgery were selected from Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology. They were randomly divided into two groups: control group (normal left Robert shaw-DLTT) and experimental group (visible left Robert shaw-DLTN). After induction of intravenous anesthesia, DLTs were placed respectively, the control group was located by auscultation, and the experimental group was located by built-in camera. Fiberoptic bronchoscopy was performed to record the hemodynamic changes after intubation. The accuracy of location was recorded when intubation was used; the trachea Carina and bronchial injury were recorded; lung collapse was recorded during operation; postoperative pharynx was recorded. The incidence of hoarseness. Results compared with the control group, After intubation, the mean arterial pressure (MAPP) and heart rate (HRR) of the patients in the experimental group were significantly lower than those in the control group (all P 0.05). The time of intubation in the experimental group was significantly shorter than that in the control group (P 0.05), and the accuracy of intubation was significantly increased (P 0.05), and the injury of tracheal protuberance or bronchial mucosa was significantly reduced (all P 0.05). The incidence of hoarseness was significantly decreased (all P 0.05). Conclusion Visual double lumen bronchial catheter can be safely used in thoracic surgery with accurate location and less complications, so it is worth popularizing in clinic.
【作者单位】：湖北省江汉油田总医院麻醉科;华中科技大学同济医学院附属同济医院麻醉科;
【分类号】：R614

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