帝视观察用内窥镜在Robertshaw双腔支气管导管插管与定位中的应用

Application of Disposcope Endoscope in the Intubation and Positioning of Robertshaw Double Lumen Bronchial Catheter

目的:本研究旨在探讨帝视内镜在Robertshaw双腔支气管导管插管与定位的应用效果。方法:选择2018年1月至2021年4月在我院行择期胸腔镜手术患者80例,随机分为内E组和M组,每组40例。两组采用Robertshaw双腔支气管导管插管全身麻醉,E组患者采用帝视内镜进行支气管插管及定位,M组患者采用Macintosh喉镜进行支气管插管,听诊法进行定位。记录两组气道评估情况;记录两组双腔支气管插管实施情况;记录两组术中单肺通气情况;记录两组患者气管插管并发症发生情况。结果:E组暴露声门时间、气管插管时间、定位时间明显低于M组(P<0.05);E组Cormach-Lehane声门暴露分级明显优于M组(P<0.05);E组首次插管成功率、MN间距明显高于M组(P<0.05),E组术中气道峰压过高、肺塌陷不良、需要调整导管位置例数明显低于M组(P<0.05),E组患者气管插管并发症总发生率明显低于M组(P<0.05)。结论:帝视观察用内窥镜能安全有效应用于Robertshaw双腔支气管导管插管的定位,与Macintosh喉镜插管听诊法比较,帝视观察用内窥镜声门暴露时间、插管时间、定位时间更短、首次插管成功率更高、并发症更少,且术中单肺通气效果更好。

Objective:The purpose of this study was to investigate the effect of disposcope endoscope in the intubation and positioning of Robertshaw double lumen bronchial catheter.Methods:80 patients undergoing elective thoracoscopic surgery in our hospital from January 2018 to April 2021 were randomly divided into group E and group M,40 cases in each group.Robertshaw double lumen bronchocatheter intubation was used in the two groups for general anesthesia.Patients in group E were intubated and positioned by disposcope endoscope,while patients in group M were intubated by Macintosh laryngoscope and positioned by auscultation.The airway evaluation of the two groups was recorded.The implementation of double lumen endobronchial intubation in the two groups was recorded.The complications of one lung ventilation in the two groups were recorded during the operation.The complications of endotracheal intubation were recorded.Results:The exposure time of glottis,intubation time and positioning time in group E were significantly lower than those in group M(P<0.05).The Cormach-Lehane glottic exposure grade of group E was significantly better than that of group M(P<0.05).The success rate of first intubation and MN spacing in group E were significantly higher than those in group M(P<0.05).The number of cases with high airway peak pressure,poor lung collapse and need to adjust the catheter position in Group E was significantly lower than that in group M(P<0.05).The total incidence of complications of tracheal intubation in group E was significantly lower than that in group M(P<0.05).Conclusion:Compared with Macintosh laryngoscope intubation auscultation method,the disposcope endoscope has shorter glottic exposure time,intubation time,positioning time,higher success rate of first intubation,fewer complications,and better effect of one lung ventilation.