新型左主支气管阻塞器与双腔支气管导管用于单肺通气的比较研究

Comparison of new type left-bronchial-blocker and double-lumen endotracheal tube used for one-lung ventilation

目的：比较新型左主支气管阻塞器（new type left-bronchial-blocker,NTLBB）与双腔支气管导管（double-lumen endotracheal tube,DLT）在开胸手术单肺通气（one-lung ventilation,OLV）中的临床应用。方法：选取2013-05-01-2013-10-30,章丘市人民医院收治的美国麻醉医师协会（American Society of Anesthesiologists,ASA）分级Ⅰ～Ⅱ级的限期开胸手术患者60例,分为NTLBB组（N组）和DLT组（D组）。观察导管置入定位时间、OLV期间气道峰压（Ppeak）、气道损伤程度以及术后咽痛和声音嘶哑发病率。结果：D组置入定位平均时间为（3.31±0.51）min,N组为（2.95±0.24）min,差异无统计学意义,P〉0.05。与双肺通气相比,2组OLV期间Ppeak均有升高,D组Ppeak升高率为（35.0±2.7）%,明显高于N组的（18.0±1.2）%,P〈0.05。N组气道损伤评分为1.42,D组为2.48;N组术后咽痛伴声嘶发生率10%（3/30）,D组为33%（10/30）;N组均明显低于D组,P〈0.05。结论：与DLT相比,NTLBB具有置入定位简单准确、肺及气道损伤小和术后并发症低等优点,值得临床推广应用。

OBJECTIVE：To compare the clinical application of one-lung ventilation between new type left-bronchial blocker（NTLBB）and double lumen endotracheal tube（DLT）in thoracic surgery.METHODS：From May 1,2013to October 30,2013in Zhangqiu People＇s Hospital 60cases of stageⅠ-Ⅱtime limited thoracic surgery patients were divided into two groups according the standard of American society of anesthesiologists（ASA）,NTLBB group（N group）and DLT（group D）.Positioning time,airway PEAK pressure during OLV catheterization（Ppeak）,airway damage degree,the incidence of postoperative sore throat and hoarse were observed.RESULTS：In the two groups the average time in group D was（3.31±0.51）min and N groups it was（2.95±0.24）min,there was no significant difference（P〉0.05）.Compared with the double lung ventilation,Ppeakduring OLV increased in both groups,rising rate group D Ppeakof（35±2.7）% was significantly greater than that of N group（18±1.2）%（P〈0.05）.Airway trauma score（N group：1.42;group D：2.48） and the incidence of postoperative sore throat with hoarsing[N group：10%（3/30）;group D：33%（10/30）]in N group was lower than that in group D（P〈0.05）.CONCLUSIONS：Compared with DLT,NTLBB is simple and accurate in positioning lung,and small airway lesions,and with low postoperative complications it is worthy of clinical popularization and application.