Coopdech封堵支气管导管联合加强型气管导管用于上纵隔肿瘤切除术患者气道管理的效果

Efficacy of Coopdech bronchial blocker combined with a strengthened single-lumen tube for airway management in patients undergoing upper mediastinal tumor resection

目的评价Coopdech封堵支气管导管联合加强型气管导管用于上纵隔肿瘤切除术患者气道管理的效果。方法拟经前外侧开胸行上纵隔肿瘤切除术患者22例，年龄24～66岁，体重48-78kg，ASA分级Ⅱ或Ⅲ级，采用随机数字表法，将患者随机分为双腔支气管导管组（Ⅰ组）和Coop—dech封堵支气管导管联合加强型气管导管组（Ⅱ组），每组11例。Ⅰ组术中采用双腔支气管导管技术行单肺通气；Ⅱ组采用Coopdech封堵支气管导管联合加强型气管导管进行气道管理，需单肺通气时可应用Coopdech封堵支气管导管进行肺隔离。两组均应用纤维支气管镜辅助气管内导管定位。记录气管插管时间、定位时间、导管移位情况、纤维支气管镜检查次数、气道峰压增加情况、肺萎陷程度、术后咽痛声嘶的发生情况、呼吸机辅助通气情况。结果与Ⅰ组比较，Ⅱ组气管插管时间缩短，导管移位的发生率、气道峰压增加率和术后咽痛声嘶发生率降低（P〈0．05或0．01），定位时间、纤维支气管镜检查次数、肺萎陷程度及术后呼吸机辅助通气发生率差异无统计学意义（P〉0．05）。结论Coopdech封堵支气管导管联合加强型气管导管用于前外侧开胸行上纵隔肿瘤切除术患者气道管理的效果优于双腔支气管导管。

Objective To evaluate the efficacy of Coopdech bronchial blocker combined with a strengthened single-lumen tube for airway management in patients undergoing upper mediastinal tumor resection. Methods Twenty-two ASA II or m patients, aged 24-66 yr, weighing 48-78 kg, scheduled for elective resection of upper mediastinal tumor, were randomly divided into 2 groups （n = 11 each） ： double-lumen tube group （group I ） and Coopdech bronchial blocker combined with a strengthened single-lumen tube group （group II ） One-lung ventila- tion was achieved with a double-lumen tube in group I The Coopdech bronchial blocker combined with a strengthened single-lumen tube was used for airway management and the Coopdech bronchial blocker was used for lung isolation when one-lung ventilation was required in group II . The fiberoptic bronchoscope was used to assist endotracheal tube positioning in both groups. The intubation time, positioning time, the nmnber of patients required for tube displacement, the number of fiberoptic bronchoscopy, increase in airway peak pressure, degree of lung collapse, postoperative sore throat and hoarseness, and the number of patients needing ventilator-assisted ven- tilation were recorded. Results The intubation time was significantly shorter, the number of patients required for tube displacement was significantly smaller, and the rate of increase in airway peak pressure and incidences of postoperative sore throat and hoarseness were significantly lower in group II than in group I[ （ P 〈 0. 05 or 0.01）. Conclusion The efficacy of the Coopdech bronchial blocker combined with a strengthened single-lmnen tube for airway management is better in patients undergoing upper mediastinal tumor resection than the double-lumen tube.