实测门齿到气管隆突的距离在肺外科手术双腔支气管导管插管中的应用

Application of Actual Distance between Incisor and Trachea Carina in Double-lumen Endobronchial Tube Intubation

目的寻求一种操作简便、安全可靠的双腔支气管导管(DLT)的插管方法。方法将90例择期行肺科手术的患者随机分成两组:试验组在术前行纤维支气管镜检查的同时测量门齿到隆突的距离和DLT管端到支气管套囊近缘的长度,用以指导DLT插管;对照组采用传统方法插管。比较两种方法插管的1次成功率、单肺通气60min时SpO2的变化以及术后与插管有关的并发症。结果试验组的1次插管成功率、单肺通气60min时SpO2<95%的发生率及并发症的发生率分别为92%、4%和6%,对照组分别为60·0%、17·5%和22·5%,两组间差别有显著性意义(P<0·05)。结论采用实测门齿到隆突的距离指导DLT插管操作简便,安全可靠,适用于基层医院。

Objective To explore an easy handling and safe method of double -lumen endobronchial tube （DLT） intubation. Methods 90 patients with pneumosurgery operation were randomly divided into two groups. In the experiment group, the distance between the incisor teeth and trachea carina and the length from the DLT to the proximal end of brachial carmula balloon were measured, which were used to guide DLT intubafion; In the control group, the traditional tracheal intubation was used. Successful rate of once intubation, SpO2 of single lung ventilation for 60 min and intubation complication after operation were compared between the two groups. Results In the experiment group, successful rate of once intubation, incidence of SpO2 〈95% and complication were 92%, 4% and 6% respectively, the parameters of the control group were 60%, 17.5% and 22. 5% respectively, there were significant difference between the two groups （ P 〈 0. 05 ）. Conclusion Actual distance between incisor teeth and trachea carina guiding DLT intubation is easily manipulcated and safe, which is worthy extending in pneumosurgery operation, especially in primary level hospitals.