支气管堵塞器在胸外科手术单肺通气中的应用研究

Application of endobronchial blocker in one-lung ventilation during thoracic surgery

目的探讨支气管堵塞器单在胸外科手术单肺通气中的应用。方法选择开胸手术需单肺通气患者40例,随机分为A组(即麻醉诱导后插入单腔气管导管,然后将支气管堵塞器沿单腔气管导管插入目标肺侧)和B组(麻醉诱导后直接插入双腔支气管导管行单肺通气)。观察记录两组插管时间、一次插管成功率、外科术野暴露及气道峰压情况。结果 A组插管时间明显短于B组,而气道峰压较B组低(P<0.05),A组一次插管成功率明显高于B组(P<0.05),两组外科术野暴露程度差异无统计学意义。结论支气管堵塞器插管方法简易,插管成功率,而且能满足胸科手术单肺通气要求,值得在临床中推广使用。

【Objective】To investigate the application of endobronchial blocker in one-lung ventilation during thoracic surgery. 【Methods】40 patients who needed one-lung ventilation during thoracotomy are selected, and randomly divided into Group A（insertion of single-lumen endotracheal tube after anesthesia induction, followed by insertion of edndobronchial blocker into the target lung side along the single-lumen endotracheal tube） and Group B（one-lung ventilation by direct insertion of double-lumen endotracheal tube after anesthesia induction）. Intubation time, one-time success rate of intubation, surgical field exposure and peak inspiratory pressure in two groups are observed, and recorded. 【Results】Group A has markedly shorter intubation time and significantly lower inspiratory pressure than Group B（P〈0.05）, as well as significantly higher one-time success rate of intubation（P〈0.05）. No statistically significant difference is found in surgical field exposure between two groups.【Conclusion】Endobronchial blocker intubation is simple, easy, and has high intubation success rate while being able to meet one-lung ventilation requirements in thoracic surgery, which is worthy of clinical application.