循序渐退法行左侧双腔支气管插管的临床研究.doc

循序渐退法行左侧双腔支气管插管的临床研究 实用医院临床杂志2011年9月第8卷第5期 循序渐退法行左侧双腔支气管插管的临床研究 颜勇军,郑珈琳,钟庆2,汪辉德2,陈涛2,邬瑞目02,陈光忠2 (1.四川省安岳县人民医院麻醉科,四川安E-642350;2,四川省简阳市人民医院麻醉科,四川简阳641400) 【摘要】目的探讨循序渐退法用于左侧双腔支气管导管(1eft.sideddoublelumenendobronchialTube,L.DLT)插管及纤 维支气管镜(fiberopticbronchoscope,FOB)辅助插入深度的定位.方法80例实施择期开胸和胸腔镜手术的全麻患者采用计 算机随机法分为传统听诊法组(A组)和循序渐退法组(w组)各40例.均采用静脉麻醉诱导,待患者意识丧失肌肉松弛后行 L—DLT操作.w组采用循序渐退法行左侧双腔支气管插管;A组按传统听诊法定位.观察定位时间,FOB检查置管深度,实际 到位率以及气管插管相关并发症.结果定位时间两组差异无统计学意义(Pgt;0.05),置管深度和实际到位率A组均明显优 干w组(Plt;0.05).经FOB检查,A组错位原因中插入过深最主要,且明显多于w组(Plt;0.05).结论循序渐退法用于左 侧双腔支气管插管,能够显着提高正确到位率. 【关键词】双腔支气管导管;纤维支气管镜;开胸手术 【中图分类号】R614.24;R616.5;R655【文献标识码】A【文章编号】1672-6170(2011J05-0060-03 Clinicalstudyongradualwithdrawalmethodwithleft.sideddouble.1umenendObrOnchial tubefortrachealintubationYANYong-jun,ZHENGJia—lin,ZHONGQing,WANGHui—de..CHENTao.,WURui— gang,CHENGuang—zhong(1.DepartmentofAnesthesiology,AnyuePeople~Hospital,Anyue642350-China;2.Departmentof Anesthesiology,JianyangPeople~Hospital,Jianyang641400,China) 【Correspondingauthor]ZHONGQ 【Abstract】ObjectiveThisstudyaimedtoinvestigativegradualwithdrawalmethodontrachealintubationbyleft—sideddouble— lumenendobronchialtube(L?DLT)andpositioningofthedepthofpenetrationfiberopticbronchoscope(FOB).MethodsEightya— dultpatientswhoscheduledforvideo—assistedor/andthoracicsurgerywererandomlyassignedtogroupA(n=40)usingtraditional auscultationmethodandgroupW(n=40lusinggradualwithdrawalmethodfortrachealintubation.Afterstandardintravenousanes— theticinduction.insertionofL-DLTwasperformed.IngroupW,gradualwithdrawalmethodwasusedtoinsertL—DLT.IngroupA, traditionalauscultationmethodwasusedtoposition.Thetimeofpositioning,depthofintubation,casesofidealanatomicplacement andincidenceofcomplicationswererecorded.ResultsTherewerenostatisticalsignificanceinthetimeoftracheaintubation(Pgt; 0.05).ThedepthofintubationingroupAwasdeeperthanthatofgroupW,butcasesofidealanatomicplacementwaslessthanthat ofgroupW(Plt;0.05).OverinsertionofL—DLT,whichwasthemainreasonsofinappropriatelocationofintubatio