文章摘要
董洪权,李娜娜,沙欢欢,周学龙.左双腔气管导管支气管套囊充气对侧卧位时导管移位率的影响[J].南京医科大学学报,2020,(12):1844~1847
左双腔气管导管支气管套囊充气对侧卧位时导管移位率的影响
Effects of air inflation of bronchial capsule on the displacement rate of left double ⁃lumen endobronchial tube during lateral positioning
投稿时间:2020-03-23  
DOI:10.7655/NYDXBNS20201220
中文关键词: 支气管套囊充气  左双腔气管导管  侧卧位  胸科手术麻醉
英文关键词: inflation of endobronchial cuff  double⁃lumen endobronchial tube  lateral position  thoracic anesthesia
基金项目:国家自然科学基金(81701375)
作者单位
董洪权 南京医科大学第一附属医院麻醉科江苏 南京 210029 
李娜娜 南京医科大学第一附属医院麻醉科江苏 南京 210029 
沙欢欢 南京医科大学第一附属医院麻醉科江苏 南京 210029 
周学龙 南京医科大学第一附属医院麻醉科江苏 南京 210029 
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中文摘要:
      目的:探讨胸科手术摆放侧卧位时,左侧双腔气管导管支气管套囊充气对体位变动时导管移位率的影响。方法:选择择期在全麻下使用左双腔气管导管行胸科手术的成人患者60例,采用随机数字表法,将患者分成两组:支气管套囊充气组(A组,n=30)和支气管套囊不充气组(B组,n=30)。全麻诱导后,可视喉镜下置入左侧双腔气管导管,纤维支气管镜下确认支气管套囊顶端置于气管隆突下方5 mm,记录中切牙处导管插管深度。A组在全麻诱导插管成功后,摆放侧卧位时,将支气管套囊充气,B组则在支气管套囊不充气情况下,摆放侧卧位。侧卧位后,观察肺隔离及通气效果,重新在纤支镜下确认支气管套囊位置,记录侧卧位后中切牙处插管深度,记录气管内导管移位距离,比较两组患者导管移位率。结果:两组共有28例(46.7%)患者摆放侧卧位后,发生双腔管移位,其中A组10例(33.3%),B组18例(60.0%),差异有统计学意义(P=0.04),两组气管移位距离分别为(9.2±1.7)mm、(9.0±1.9)mm,差异无统计学意义(P > 0.05)。结论:胸科手术摆放侧卧位时,气管导管容易发生移位,支气管套囊充气与不充气相比,能够显著降低侧卧位时左双腔气管导管移位的发生率。
英文摘要:
      Objective:This study was designed to assess whether inflation of the endobronchial cuff before lateral positioning would further secure a double?lumen endobronchial tube(DLT)and reduce movement. Methods:Sixty adult patients requiring one?lung ventilation were randomly enrolled into either the endobronchial cuff?inflated group(Group A)or the deflated group(Group B) during lateral positioning. Patients were intubated with a DLT under general anesthesia. Intubation depth was recorded. After the DLT was successfully intubated,the bronchial cuff was inflated in group A while the cuff was not inflated in group B when the lateral position was placed. Location of the double lumen was observed by fiberoptic bronchoscopy in the supine and the lateral position. The incidence and distance of the double lumen displacement in the two groups were recorded(defined as the distance from the tip of the trachea cavity of the double lumen to the trachea carina). Results:A total of 28 patients(46.7%)in the two groups underwent double lumen displacement after lateral decubitus placement,including 10 patients in group A(33.3%)and 18 patients in group B(60.0%). There were sigrificant differences between group A and group B (P=0.04). The displacement distances of the two groups were (9.2±1.7) mm and (9.0±1.9) mm,respectively,with no significant difference(P > 0.05). Conclusion:When placing the lateral position in thoracic surgery,the DLT is prone to displacement. Inflation of endobronchial cuff can significantly decrease the incidence of displacement of the DLT during lateral positioning.
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