纤维支气管镜引导双腔支气管导管插管在全身麻醉中的应用

Double-lumen endobronchial tube intubation by fiberobronchoscope in general anesthesia

择期全麻下行胸腹腔镜联合食道癌根治术患者62例[美国麻醉医师协会(ASA)Ⅰ或Ⅱ级]随机均分为纤维支气管镜(FB)组和直接喉镜组。采用脑电双频指数(BIS)监测、靶控输注(TCI)丙泊酚全凭静脉麻醉,记录插管时间、定位完成时间、插管期各时间点的心率(HR)、平均动脉压(MAP)值、单肺通气时血氧饱和度(SpO2)平均值及体位改变后需要调整导管位置的病例数。FB组与直接喉镜组比较,插管时间无明显差异,HR、MAP波动小(P<0.05),单肺通气时SpO2平均值高(P<0.05)、定位完成时间较短,体位改变后需要调整导管位置次数少(P<0.05)。

Sixty-two cases of ASAⅠorⅡ stage patients with esophageal cancer were randomly divided into 2 groups after treatment of laparoscopy combined with thoracoscopy under genezal anesthesia： fibero bronchoscopy group and direct laryngoscopy group.Total intravenous anesthesia with propofol was used during operation,and the following data were recorded： HR,mean arterial pressure（MAP）,duration of intubation,positioning completion time,SpO 2 average of one-lung ventilation and the cases of catheter position adjustment after postural change.Compared with the direct laryngoscopy group,the fluctuations of HR,MAP in FB group were smaller during bronchoscopy insertion（P 〈0.05）,average SpO 2 of one-lung ventilation was higher（P 〈 0.05）,time of the positioning completion was less（P 〈 0.05）,and less adjustments of catherter position after postual change in FB group（P 〈 0.05）.