一种改良双腔气管导管定位方法的临床应用

Clinical Application of an Improved Positioning Method for Double-Lumen Endotracheal Tube

目的观察一种改良双腔气管导管定位方法的成功率。方法选取行左侧双腔气管插管的患者60例,随机分为两组,每组30例。对照组C组为传统定位组,采用常规听诊法确定肺隔离效果及气管导管位置。观察组K组为改良定位组,插入双腔气管导管后,将支气管套囊充气,连接呼吸回路后,向外退双腔气管导管直到听到主管漏气为止,然后再将双腔管向内置入1.5 cm固定气管导管。两组均用纤维支气管镜确认气管导管的位置。比较两组插管定位成功率、插管定位时间。结果两组患者一般资料比较,差异无统计学意义。两组患者插管定位成功率的比较,K组成功率明显高于C组,差异有统计学意义(P<0.05)。两组插管定位时间比较,K组明显小于C组,差异有统计学意义(P<0.05)。结论这种改良的双腔管定位方法操作简便定位成功率高,插管定位时间短,易于掌握,在没有纤支镜的情况下也能准确定位,值得临床推广。

Objective To observe success rate of an improved positioning method for dual-lumen endotracheal tube.Methods 60 patients who underwent double-lumen endotracheal intubation on the left were selected and randomly divided into two groups with 30 cases in each group.Control group(group C)was traditional positioning group,using conventional auscultation to determine lung isolation and tracheal tube.Observation group(group K)was modified positioning group that after inserting double-lumen endotracheal tube,inflating bronchial cuff and connecting breathing circuit,tube was withdrawn outwards until main pipe leaked and placed inside 1.5 cm to fix tracheal tube.Both groups used fiberoptic bronchoscopy to confirm position.Success rate of intubation positioning and intubation positioning time were compared.Results There was no statistically significant difference in general information.For success rate of intubation positioning,group K was significantly higher than group C with statistically significant difference(P<0.05).For intubation positioning time,group K was significantly shorter than group C with statistically significant difference(P<0.05).Conclusion Improved dual-lumen tube positioning method is easy to operate with high positioning success rate,short intubation positioning time.It could be accurately positioned without bronchoscopy,which is worthy of clinical promotion.