可视型双腔支气管导管与普通型双腔气管导管在胸部创伤急诊手术中的比较

Application of visual double lumen endotracheal tube in emergency operation of severe chest trauma

目的:比较可视型双腔支气管导管(VDLT)与普通型双腔气管导管(DLT)在胸部创伤急诊手术中的效果。方法:选择2020年5月-2021年1月期间收治的需急诊开胸探查手术治疗的胸部损伤患者50例,随机分为两组,每组25例。试验组:使用可视型双腔支气管导管进行气管插管,对照组:使用常规双腔支气管导管进行气管插管。单肺通气,观察插管时间、首次定位准确率,插管过程中外部辅助操作次数,气管损伤率,术中出血量,术后咽喉疼痛及声音嘶哑等发生率、住院时间。结果:所有病例均顺利完成手术,无死亡病例,试验组首次插管成功率高于对照组;术中调整导管时间及手术时间试验组短于对照组;术中出血量试验组较对照组少;管错位率和口腔黏膜损伤率、咽喉部疼痛发病率和声音嘶哑发生率均低于对照组;在按压喉部的次数及住院时间两组差异无统计学意义。结论:可视型双腔支气管导管具有插管准确性高、首次插管成功率高、速度快、利于术中准确调整管道等优势,在急诊胸外伤手术中可以缩短手术抢救时间,提高救治率。

Objective:To compare the effect of visual double-lumen tube(VDLT)and common double-lumen tube(DLT)in emergency operation of chest trauma.Methods:From May 2020 to January 2021,50 patients with chest injury who needed emergency thoracotomy and exploration surgery were selected and randomly divided into two groups,with 25 in each.The patients in the experimental group were intubated with VDLT and the patients in the control group were intubated with conventional DLT.The intubation time,the accuracy of the first positioning,the number of external auxiliary operations during intubation,the rate of tracheal injury,the amount of intraoperative blood loss,the incidence of postoperative throat pain and hoarseness,and the length of hospital stay were observed.Results:The operation was successfully completed in all cases without death.The success rate of the first intubation in the experimental group was higher than that in the control group;The time of adjusting catheter and operation time in the experimental group were shorter than those in the control group.The amount of blood loss in the experimental group was less than that in the control group;The incidence of tube dislocation,oral mucosa injury,sore throat and hoarseness was lower than that in the control group.There was no difference in the number of times of pressing throat and the length of hospital stay between the two groups.Conclusion:VDLT has the advantages of high intubation accuracy,high success rate of first intubation,fast speed,and accurate adjustment of the tube during operation.It can shorten the operation rescue time and improve the treatment rate in emergency thoracic trauma surgery.