帝视内窥镜硬镜在左侧双腔支气管插管中的临床应用

Clinical application of disposcope endoscope for left-sided double-lumen tube intubation

目的探讨帝视内窥镜硬镜与纤维支气管镜在左侧双腔支气管插管中的应用比较。方法60例本院2017年1月至2018年10月行全麻下胸腔镜肺手术患者,ASA分级为Ⅰ~Ⅲ级,年龄15~79岁,随机分为两组纤支镜组(A组)和帝视组(B组)。A镜组采用喉镜经口置入左侧双腔支气管导管,使用纤支镜进行定位;B组预先将帝视内窥镜硬镜镜体置入左侧双腔支气管导管右侧管腔,采用喉镜经口置入气管导管,并定位。记录完成插管时间(从开始左侧双腔支气管插管到完成正确定位的时间)、左侧双腔支气管插管定位一次性成功次数,以及更换体位后气管导管移位发生情况。结果两组患者年龄、身高、体重、性别、ASA分级和Mallampati分级比较差异无统计学意义(P>0.05);B组完成插管时间短于A组(P<0.01),且一次性成功率高于A组(P<0.01);两组患者更换体位后,导管均未发生移位。结论帝视内窥镜硬镜可有效缩短左侧双腔支气管导管插管时间,提高插管定位一次性成功率。

Objective To compare the effect of disposcope endoscope for left-sided double-lumen tube intubation with fibreoptic bronchoscopy.Methods 60 Ⅰ~Ⅲ ASA patients aged from 15 to 79 years old received left-sided double-lumen endobronchial tube undergoing general anesthesia for video-assisted thoracoscopic surgery were randomly divided into two groups,with 30 cases in each group.Disposcope endoscope was used to assisted left-sided double-lumen tube placement in the group A,and fibreoptic bronchoscopy was used in the group B.The intubation placement time and the rate of the first successful intubation were recorded.Then the correctly position of endobronchial tube was checked in the two groups after posture changing.Results Their demographics were similar between the two groups ( P> 0.05).The group A had a shorter intubation placement time than that in the group B ( P< 0.01),and the rate of first successful intubation was higher in the group A than the group B ( P< 0.01).Then the position of endobronchial tube was all correctly in the two groups.Conclusion Disposcope endoscope can shorten the intubation placement time and increase the rate of first successful double-lumen endobronchial tube placement.