乳腺癌手术应用食管-气管导管对全麻气道管理的临床效果观察

Effect of The Combitube in Airway Management During General Anesthesia Under Breast Cancer Operation

目的 :评估食管 气管导管 (Combitube)在中小手术麻醉全程中使用的通气和换气功能。方法 :乳腺癌病人 38例 ,随机分入两组。Combitube组 (C组n =19) ,气管导管组 (T组n =19)。诱导后喉镜明视下C组食管插入Combitube ,T组经声门插入气管导管。麻醉中呼吸参数设定相同。使用Datex OhmedaS 5监测围术期的血流动力学、通气功能及气道力学的变化 ,并随访术后并发症。结果 :插管前两组间的各种参数无差异 ,插管时两组间SBP、DBP、HR、SpO2 、ETCO2 无明显差异 (P >0 .0 5 )。C组吸气峰压 (Ppeak)明显高于T组 ;一秒率 (FEV 1.0 % )和肺顺应性 (CL)术中明显降低 ,且与T组比较差异非常显著 (P <0 .0 1)。C组FEV 1 0 %ETCO2 和CL在插管后 5 5分钟与插管后 5分钟比较有明显变化 (P <0 .0 5 )。手术后并发症两组间无差异 (P >0 .0 5 )。结论 :Combi

Objective: To evaluate the efficiency and the safety of the ventilation and respiratory functions of the Combitube during general anesthesia.Methods:38 breast cancer operable patients were randomized to two groups:Group C(Combitube n=19 )and Group T(Tracheal tube n =19).The Combitube was intubated into esophagus of patient for group C and tracheal tube for group T after induction.Hemodynamic and ventilation function parameters were monitored(Datex Ohmeda S/5 monitor).Results:There were no significant parameter differences between the two groups before induction.Marked changes in SBP?DBP?HR?SPO 2 and ETCO 2 were not found between the two groups during operation( P>0.05 ).Lung compliance (C L)and one second forced expiratory flow rate(FEV1.0%)were decreased significantly and peak pressure(Ppeak)was increased significantly after Combitube intubation.There was significantly difference between two groups( P<0.01 ).Marked changes in C L,FEV1.0%,ETCO 2 were found in group C after intubation 55 min( P<0.05 ).Conclusion:It is safe and effective by using Combitube to anesthetic management during medium or brief operations.