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支气管堵塞器与双腔支气管导管在胸腔镜手术中的应用比较 被引量:14

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摘要 目的比较支气管堵塞器与双腔支气管导管应用于胸腔镜手术中的临床效果。方法选择在电视胸腔镜辅助下行肺大泡切除术和肺叶楔形切除术患者60例,随机分为双腔支气管导管组(A组)和Coopdech支气管封堵器组(B组),比较两组的插管定位时间、一次性插管成功率、插管前后的血流动力学变化、术中肺最大程度萎陷所需时间及萎陷情况、术中单肺通气前后的脉搏血氧饱和度(SpO2)及气道压峰值、术后患者声音嘶哑、咽喉痛发生率及患者的满意度。结果 B组插管定位时间、术中肺萎陷情况、术中SpO2与A组比较差异无统计学意义(P>0.05),B组肺最大程度萎陷所需时间较A组长,但一次性插管成功率较高(P<0.05)。与插管前比较,插管后A组平均动脉压(MAP)升高及心率(HR)加快较B组明显(P<0.05)。与单肺通气前(ALV)比较,单肺通气后(OLV)B组气道峰压值升高明显低于A组(P<0.05)。B组术后声音嘶哑及咽喉痛发生率也明显低于A组(P<0.05),且B组患者术后满意度较高(P<0.05)。结论双腔支气管导管与支气管封堵器应用于胸腔镜手术中均可取得良好的肺隔离效果。后者与前者比较对患者刺激更小,单肺通气前后气道压变化不明显,术后声音嘶哑、咽喉痛发生率较低,但肺萎陷较慢且吸痰不方便。两者用于胸腔镜手术各有利弊,临床上应酌情选择。
出处 《广东医学》 CAS CSCD 北大核心 2012年第8期1163-1165,共3页 Guangdong Medical Journal
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