Coopdech支气管封堵器对开胸手术病人通气效果的影响

Effect of Coopdech endobronchial blocker tube on ventilation in patients with thoracotomy

目的:评价Coopdech支气管封堵器在开胸手术中对选择性肺叶隔离病人通气效果的影响。方法:择期行VATS右肺中或下叶部分切除术病人40例,随机分为双腔支气管导管组(V组)和Coopdech支气管封堵器组(C组)。V组:选择合适型号的双腔支气管导管行单肺通气。C组:经口插入单腔气管导管,然后将润滑后的Coopdech支气管封堵器置入单腔气管导管中;使用小儿纤维支气管镜定位,将Coopdech支气管封堵器置入右中间支气管开口内约0.5cm,使套囊位于右上肺叶支气管开口下,行左侧肺叶和右肺上叶通气。于麻醉诱导后(T0)、OLV/左肺和右上肺叶通气后20min(T1)、OLV/左肺和右上肺叶通气后60min(T2)、恢复TLV10min(T3)采桡动脉血3ml做血气分析,记录Pa O2、Pa CO2及气道平台压,气道峰压。结果:与V组比较,C组病人T1,2时Pa O2升高,气道峰压及气道平台压下降(P<0.05),两组间及组内Pa CO2均无统计学差异。结论:Coopdech支气管封堵器在选择性肺叶隔离通气时可精确合理控制肺叶隔离;改善氧合、降低气道压。

Objective：To evaluate the effect of Coopdech endobronchial blocker tube on blood gas concentration in the selective lobar blockade patients with ventilation. Methods：Forty patients undergoing right-sided lung resection VATS were randomly divided into double lumen endobronchial tube group （group V,n=20） in which double lumen endobronehial tube was performed for one lung ventilation,and Coopdech endobronchial blocker tube group （group C,n =20） in which the single lumen endotracheal tube and then Coopdech endobronchial blocker tube were performed for the left lung and right upper lobe of lung ventilation. Blood samples were taken from radial artery for determination of the blood gas. Results： Compared with group V, PaO2 at T1,T2 were increased in group C in which there was significant difference （P〈0.05）. Compared with group V ,the peak airway pressure and platforms airway pressure were reduced in which there were significant difference （P〈0.05）. Conclusion：Coopdech endobrouchial blocker tube can improve ventilation efficiency and lung protective effect,and can improve oxygenation and reduce the airway pressure.