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胸科手术中双腔支气管导管与支气管内堵塞导管对气道损伤的比较 被引量:4

Effects on airway damage between double-lumen tube and COOPDECH bronchial blocker used in thoracic surgery
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摘要 为了比较双腔支气管导管与支气管内堵塞导管对气道损伤的影响,选取拟行肺癌根治术患者80例,美国麻醉医师协会分级(ASA分级)Ⅰ~Ⅱ级,随机分为双腔支气管导管组(D组,n=40)和支气管内堵塞导管组(C组,n=40)两组。术中观察肺叶塌陷与术野暴露情况。术毕,于拔管前后分别以支气管镜、直视喉镜检查气道、声带的损伤情况。记录麻醉苏醒后即刻、术后1、2、3d患者声嘶及咽喉疼痛情况。单肺通气过程中肺塌陷情况D组优于C组(35例vs 24例,P=0.01)。D组患者拔管后声带损伤发生率显著高于C组〔D组47.4%(18/38),C组20.5%(8/39),P=0.028〕,两组患者拔管前气道损伤差异无统计学意义。D组患者术后声嘶发生率显著高于C组〔D组52.6%(20/38),C组23.1%(9/39),P=0.023〕,两组患者术后咽喉疼痛发生率差异无统计学意义。初步研究结果提示,双腔支气管导管较支气管内堵塞导管能够提供满意的肺隔离效果,但易导致术后声带损伤及声嘶发生。 The objective of this study was to compare the effects on airway damage between double-lumen tube and coopdech bronchial blocker used in thoracic surgery. Eighty ASA I or II patients scheduled for thoracic surgery were randomized into two groups:double-lumen tube group (group D,n= 40) and coopdech bronchial blocker group (group C, n=40). Lung collapse and surgical exposure of operative field during surgery were observed. The damage of airway and vocal cord were assessed before and after extubation by bronchofibroscope and laryngoscope. The incidence of postopera- tive hoarseness and sore throat were recorded after anesthesia and following three days after operation. Results lung col- lapse degree was significantly lower in group D (35 vs 24, P=0. 01). The incidence of vocal cord damage was significantly higher in group D 47.4%(18/38) than that in group C 20.5%(8/39) ,P=O. 028,while the severity of airway damage be- tween two groups showed no statistical difference. Compared with group C 23.1%(9/39),the incidence of postoperative hoarseness was significantly increased in group D 52.6 % (20/38), P= 0. 023. There were no significant differences in sore throat between two groups. In conclusions, double-lumen tube can provide favourable lung isolation, but it can induce postoperative vocal cord damage and hoarseness.
作者 沈华 孙莉
出处 《中华肿瘤防治杂志》 CAS 北大核心 2012年第12期938-940,共3页 Chinese Journal of Cancer Prevention and Treatment
关键词 麻醉/方法 插管法 气管内 导管 留置 anesthesia/methods intubation,intratracheal catheters,indwelling
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参考文献7

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