胸科麻醉选择性肺段通气导管的设计

Design of selective segmental ventilation catheter for thoracic anesthesia

目的:设计一种新型胸科麻醉气道管理器具,降低胸科手术单肺通气低氧血症的发生率。方法:根据成人气道解剖数据和气管导管内径,设计选择性肺段通气导管的外形和长度。气体在双腔气管导管内流动时产生气道阻力,以流体力学原理计算可通气的最小内径并验证。结果:在长度确定的条件下,选择性肺段通气导管放置于双腔气管导管内,可满足男性通气的最小半径为0.243 mm,满足女性通气的最小半径为0.228 mm。根据上述计算结果,最小半径的选择性肺段通气导管可进行有效吹气,在导管末端通气压力设定为20 cmH2O,导管吹出气体的流速为0.5 m/s。结论:此新型器具管径细,对局部肺段的通气流速压力安全,有望改善患者单肺通气期间的低氧血症。

Objective To design a new type of airway management device for thoracic anesthesia to reduce the incidence of onelung ventilation hypoxemia in thoracic surgery.Methods According to the adult airway anatomical data and the inner diameter of double-lumen endobronchial tube(DLT),the configuration and length of the selective segmental ventilation catheter was designed.Based on the airway resistance generated by the gas flow in the catheter of DLT,the minimum inner diameter that can be ventilated was calculated and verified by hydrodynamic principles.Results Under the condition of length determination,the selective segmental ventilation catheter is placed in the DLT,and the minimum radius for selective segmental ventilation is 0.243 mm in male,and 0.228 mm in female.According to the above calculation results,the selective segmental ventilation catheter with the minimum radius can be effectively insufflated.And it did work with flow rate of 0.5 m/s under a fixed mean ventilation pressure of 20 cmH2 O.Conclusion This new slim-diameter device with a safe ventilation flow rate and airway pressure in pulmonary segments is expected to alleviate hypoxemia during one-lung ventilation in patients.