可视双腔支气管导管在肥胖患者单肺通气中的应用效果观察

Observation on effect of visual double-lumen bronchial catheter in one-lung ventilation of obese patients

  • 摘要:
      目的  观察可视双腔支气管导管在肥胖肺癌患者开胸手术气管插管和肺隔离中的应用效果。
      方法  选取55例肥胖肺癌患者作为研究对象,剔除7例后,将患者随机分为可视组和对照组,每组24例。麻醉诱导后,可视组行可视左双腔支气管导管置入,对照组行左双腔支气管导管置入。比较2组患者导管置入时间和给药前5 min (T1时点)、诱导前即刻(T2时点)、双腔支气管导管置入即刻(T3时点)、置入后3 min (T4时点)、置入后5 min (T5时点)的平均动脉压(MAP)、心率(HR)变化,并比较2组术中导管移位情况、气管损伤情况和术后咽部疼痛、声音嘶哑情况。
      结果  可视组气管插管时间、气管插管移位后重新定位时间短于对照组,气管支气管损伤轻于对照组,差异有统计学意义(P < 0.05);可视组术后咽部疼痛、声音嘶哑发生率低于对照组,差异有统计学意义(P < 0.05);T3时点,可视组MAP、HR均低于对照组,差异有统计学意义(P < 0.05)。
      结论  可视双腔支气管导管可明显缩短气管插管时间,减少气管插管时MAP的波动,减轻气管支气管损伤,降低术后咽部疼痛、声音嘶哑发生率。

     

    Abstract:
      Objective  To observe the application effect of visual double-lumen bronchial catheter in tracheal intubation and lung isolation in obese patients with thoracotomy.
      Methods  A total of 55 obese patients with lung cancer were selected, and were randomly divided into visual group (n=24) and control group (n=24) after 7 cases were excluded. In the visual group, the patients were performed visual left double-lumen bronchial catheter, and those in the control group were given left double-lumen bronchus catheter. The changes of mean arterial pressure (MAP), and heart rate (HR) in two groups were compared at the time points of catheter placement, 5 min before administration (T1), immediately before induction (T2), immediately after double lumen bronchial catheter placement (T3), 3 min after implantation (T4), and 5 min after implantation (T5). Intraoperative catheter displacement, tracheal injury, postoperative pharyngeal pain and hoarseness were compared between the two groups.
      Results  Compared with the visual group, the tracheal intubation time and repositioning time after translocation of endotracheal intubation were significantly shorter, and injury of trachea and bronchus was lighter than those of the control group (P < 0.05). Compared with the visual group, The incidence rates of postoperative pharyngeal pain and hoarseness in the visual group were significantly lower than those in control group (P < 0.05). At T3, MAP and HR in the visual group were lower than those in the control group(P < 0.05).
      Conclusion  Visible double-lumen bronchus can significantly shorten the time of tracheal intubation, reduce the fluctuation of MAP during tracheal intubation, alleviate tracheobronchial injury, and reduce incidence of postoperative pharyngeal pain and hoarseness.

     

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