摘要
目的 探寻Mallinckrodt双腔支气管导管 (DLT)插管深度与患者身高之间的关系。方法 第一阶段选择胸科手术成年患者 370例 ,分为男性左DLT组 (ML组 )、女性左DLT组 (FL组 )、男性右DLT组 (MR组 )和女性右DLT组 (FR组 )。静脉诱导后插入选定的MallinckrodtDLT。听诊法调整管端位置 ,测量插管深度 (ID 1)。纤维支气管镜 (FB)直视下调整管端位置 ,再次测量插管深度 (ID 2 )。以患者身高和ID 2推导不同组别的回归方程。第二阶段 330例胸科手术患者 ,插入选定的DLT后 ,用听诊法和相应组别的回归方程所计算的插管深度调整管端位置 ,测量插管深度 (ID 3)。在FB直视下确认管端正确到位后 ,再次测量导管插管深度 (ID 4)。结果 根据 370例观测 ,听诊法确认双腔管管端已正确到位 ,与FB检查符合的仅 16 9例 ,错位率达 5 4 3%。FB确认管端正确到位时 ,ML组插管深度 (30 9± 1 8)cm比FL组 (2 8 3± 1 3)cm平均深 2 6cm(P <0 0 1) ,MR组 (30 2± 1 7)cm比FR组 (2 7 9± 1 6 )cm平均深 2 3cm(P <0 0 1)。插管深度与患者身高呈高度相关 (P<0 0 1)。第二阶段研究中按听诊法和相应回归方程计算值调整插管深度后 ,管端错位率比第一阶段降低了 6 0 % (P <0 0 1)。
Objective To seek the relationship between body height and depth of tube placement (DT)of Mallinckrodt double-lumen endobronchial tube (DLT).Methods In the first stage,370 adults undergoing thoracic operations were randomly divided into four groups:male left-sided double-lumen tube group (group ML),female male left-sided double-lumen tube group (group FL),male right-sided double-lumen tube group (group MR),and female right-sided double-lumen tube group (group FR),respectively.After anesthesia induction,a selected Mallinckrodt DLT was inserted.Dosition of the tube was adjusted by auscultation and the depth of tube placement (DT-1) recorded.Position of the tube was readjusted with a fiberotic bronchoscope (FB),and the depth of the tube (DT-2) recorded again.A regressive equation of body height and DT-2 was deduced in each group.In the second study,DLT was inserted in 330 patients undergoing thoracic surgery.Position and depth of DLT (DT-3) were adjusted and measured according to auscultation and the regressive equation obtained from the first study.The position and depth of DLT (DT-4) were checked and readjusted with FB.Results Of 370 cases,201(54.3%) DLT insertions were malpositioned comfirmed by FB,although all insertions were belived in normal position with auscultation in the first study.Depth of DLT in group ML (30.9±1.8cm) was significantly deeper than that in group FL(28.3±1.3)cm(P<0.01).Body height and depth of tube plaement are highly possitively correlated.In the second study,when DLT was positioned by auscultation and the regressive equation,the incidence of DLT malposition was decreased by 60% after checking with FB.Conclusion There is a high possitive correlation between the depth of Mallinckrodt DLT and body height.The incidence of malpositioning DLT is high if checked by auscultation only,which can be improved by auscultation together with the regressive equation of present study.
出处
《临床麻醉学杂志》
CAS
CSCD
2002年第7期348-350,共3页
Journal of Clinical Anesthesiology
