支气管封堵器与双腔支气管导管用于单肺通气肺塌陷的效果比较

Comparison of the effects of bronchial blocker and double-lumen endotracheal tube on lung collapse during one-lung ventilation

目的比较支气管封堵器(BB)与双腔支气管导管(DLT)用于单肺通气(OLV)肺塌陷的效果,旨在为临床应用提供参考。方法选择2020年10月至2022年9月于我院择期行胸腔镜下右肺叶切除术的40例患者为研究对象,按肺塌陷方式不同将其分为BB组和DLT组,每组20例,BB组和DLT组中分别有2、1例发生低氧血症,改为双肺通气,剔除研究,最终BB组18例、DLT组19例完成研究。BB组将BB用于OLV肺塌陷,DLT组将DLT用于OLV肺塌陷。比较两组的应用效果。结果两组的肺塌陷评分(LCS)比较,差异无统计学意义(P>0.05)。侧卧位即刻(T_(1))~开胸后5 min(T_(4)),两组的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))及动脉血氧分压(PaO_(2))比较,差异无统计学意义(P>0.05);BB组和DLT组分别有2例和3例患者发生SpO_(2)下降,但均未出现低氧血症。BB组和DLT组开胸时肺塌陷均较优,术侧肺完全萎陷,手术视野暴露满意。结论BB可有效完成开胸前肺塌陷,对开胸前肺塌陷的影响及OLV效果与DLT相当,可将其推广应用于临床当中。

Objective To compare the effects of bronchial blocker(BB)and double-lumen endotracheal tube(DLT)on lung collapse during one-lung ventilation(OLV),and to provide references for clinical application.Methods Forty patients who underwent thoracoscopic right lobectomy in our hospital from October 2020 to September 2022 were selected as the research objects.According to the different ways of lung collapse,the patients were divided into BB group and DLT group,with 20 cases in each group.Two cases and one case of hypoxemia occurred in the BB group and the DLT group respectively,which were changed to two-lung ventilation.After excluding the study,18 cases in the BB group and 19 cases in the DLT group completed the study.BB was used for OLV lung collapse in the BB group,and DLT was used for OLV lung collapse in the DLT group.The application effects of the two groups were compared.Results There was no significant difference in Lung Collapse Score(LCS)between the two groups(P>0.05).From the time of lateral position(T_(1))to 5 min after thoracotomy(T_(4)),there were no significant differences in mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO_(2))and partial pressure of oxygen in arterial blood(PaO_(2))between the two groups(P>0.05);two and three patients in the BB group and the DLT group had decreased SpO_(2),respectively,but no hypoxemia occurred.In the BB group and the DLT group,the lung collapse was better during thoracotomy,the lung on the operative side was completely collapsed,and the surgical field exposure was satisfactory.Conclusion BB can effectively complete the lung collapse before thoracotomy,and its influence on the lung collapse before thoracotomy and the effect of OLV are equivalent to DLT,which can be popularized and applied in clinical practice.