左侧双腔管支气管插管在左进胸胸科手术的临床应用

Clinical application of left side double-lumen in left chest surgery

目的探讨左进胸胸科手术患者实行左侧双腔支气管插管的可行性和安全性。方法选择本院80例左进胸胸科手术患者,随机分为左侧双腔管支气管插管组(L组)和右侧双腔管支气管插管组(R组),每组40例。全麻诱导后,分别插入左或右侧双腔管,观察比较两组患者一次性插管成功率、导管移位率、术后插管相关并发症及术中单双肺通气时的通气氧合情况的差异。结果 L组的一次性插管成功率明显高于R组,L组的导管移位率、术后插管相关并发症发生率明显低于R组,差异有统计学意义(P<0.05)。两组患者术中单双肺通气时的通气氧合情况无明显差异(P>0.05)。结论选择左侧双腔管支气管插管,可以获得同样的通气氧合效果,但一次性插管成功率更高,导管移位和术后插管并发症发生率更低,临床可优先选用。

Objective To evaluate the feasibility and safety of left double-lumen endobronchial intubation in patients undergoing left thoracic surgery. Methods Eighty patients undergoing left thoracic surgery were randomized into left double-lumen endobronchial intubation group （Group L） and right double-lumen endobronchial intubation group （Group R） （n = 40/group）. After induction of anesthesia, double-lumen tube was intubated. Success rate of one-time intubation, rate of catheter displacement, postoperative complication with intubation and intraoperative ventilation oxygenation were compared between the two groups. Results The success rate of one-time intubation was significantly higher in Group L than in Group R. Catheter displacement rate and intubation related complication were significantly lower in Group L than in Group R （ P 〈 0.05 ）. There was no significant difference in ventilation and oxygenation （ P 〉 0.05 ）. Conclusion The left double-lumen endobronchial intubation can provide the same effect of ventilation and oxygenation, with higher success rate of one-time intubation and lower rates of catheter displacement and complications.