纤维支气管镜在双腔支气管导管插管定位中的应用

Application of fiberoptic bronchoscope in positioning double-lumen endobronchial tube

目的探讨纤维支气管镜在双腔支气管导管(DLT)插管定位中的应用价值。方法择期DLT插管下行肺叶切除术患者42例,随机分为两组,分别采用纤维支气管镜定位(A组,22例)和听诊法定位(B组,20例)。记录平卧位和侧卧位时导管深度、气道峰压、脉搏氧浓度(SpO2)。对术中单肺通气时出现高气道压或脉搏氧浓度下降患者,给予纤维支气管镜检查,记录发生原因。结果患者从平卧位改为侧卧位后,A组导管错位发生率明显低于B组(9.1%vs.60.0%)(P<0.01)。单肺通气期间,B组导管错位发生率为25.0%,而A组无错位病例(P<0.01)。结论与常规听诊法定位比较,纤维支气管镜DLT定位快捷、准确。

Objective To evaluate the role of fiberoptic bronchoscope（FOB） in positioning double-lumen endobronchial tube（DLT）.Methods DLT was inserted in 42 patients undergoing lung surgery.For positioning DLT,FOB was used in 22 cases（group A） and conventional ausculation method was performed in 20 cases（group B）.The depth of tube insertion,peak pressure of airway（Paw） and pulsed oxygen saturation（SpO2） were recorded.Fiberoptic bronchoscopy during operation was carried out when Paw increased and/or SpO2 decreased during one-lung ventilation.Results The incorection rate of DLT after the position of patient was changed from supine to lateral was lower in group A than that in group B（9.1% vs.60.0%）（P0.01）.During one-lung ventilation,the incorection rate of DLT was lower in group A than that in groupB（0% vs.25%）（P0.01）.Conclusion Compared to conventional ausculation method,positioning DLT with FOB is simple with high accuracy rate.