左支气管内径值对双腔支气管导管型号选择的指导作用

The guiding role of the left bronchial inner diameter in the choice of double - lumen endobronchial tube size

目的探讨左支气管内径值在双腔支气管导管（DLT）型号选择中的指导作用。方法将300例使用左DLT进行单肺通气的择期胸外科手术患者，随机数字表法分为两组，即：A组（传统方法组：根据患者身高、体质量选择左支气管导管型号）、B组（左支气管内径值组：根据螺旋CT测量患者的左支气管内径值选择合适导管），每组150例。记录每位患者的年龄、性别、身高、体质量、疾病种类、使用的左DLT型号、导管合适度评价指标、肺萎陷质量、术后24h并发症的发生情况，对记录指标进行统计学分析。结果两组年龄、性别、身高、体质量及病种构成差异均无统计学意义（均P〉0．05）；与A组比较，B组使用的左DLT的型号大（0=8．650，P〈0．05），导管的适合度高（P〈0．01），肺萎陷质量高（X^2=6．549，P〈0．05），并且术后24h并发症的发生率低（X^2=3．991，P〈0．05）。结论根据螺旋cT测量左支气管内径值能较准确选择合适的导管型号，在DLT使用中具有指导作用。

Objective To explore the guiding role of the left bronchial inner diameter in the choice of double-lumen endobronchial tube （DLT） size. Methods 300 patients underwent elective thoracic surgery who required one-lung ventilation by intubating with left DLT were randomly divided into two groups. In A group（ traditional method group） ,the left DLT size was selected according to the patients＇ height,weight. In B group（the left bronchial inner di- ameter group） ,the left DLT size was selected according to the patients＇ inner diameter of the left main bronchus measurement under spiral CT,150 cases in each group. The patients＇ age, sex, height, weight, types of diseases, left DLT size,catheter-fit evaluation, the level of pulmonary collapse state and postoperation complications in 24 hours were recorded and analyzed. Results The age, sex, height, weight and the types of diseases between the two groups had no significant differences（ P 〉0.05 ）. Compared with group A, in group B the left DLT size was greater（ X^2 = 8. 650 ,P 〈 0.05 ）, catheter-fit evaluation was higher （P 〈 0. O1 ）, the level of pulmonary collapse state was better （X^2 --6. 549, P 〈 0.05）, and the incidence rate of postoperation complications in 24 hours was lower （ X^2 = 3. 991, P 〈 0.05 ）. Conclusion The DLT size was selected according to the patients＇ inner diameter of the left main bronchus measurement under spiral CT might be relatively more appropriate and accurate, and this method might play a guiding role in the clinical use of DLT.