摘要
目的探讨单腔支气管导管(SLBT)在胸腔镜手术麻醉中的应用效果。方法选取2020年1—10月解放军第九七〇医院收治的60例行胸腔镜下肺大疱切除、肺楔形切除、肺段或肺叶切除的患者,男29例,女31例,年龄(55.2±14.6)岁,年龄范围为17~87岁。采用随机数表法将所有患者随机分为SLBT组和双腔支气管导管(DLBT)组,每组30例。比较两组患者的插管时间、插管后定位时间、摆放体位后定位时间、单肺通气后肺塌陷时间、手术视野暴露情况,单肺通气5 min后气道峰压及术中导管移位次数,患者完全清醒拔管后即刻、术后24 h、术后72 h的咽痛及声音嘶哑情况。结果SLBT组患者插管后定位时间[(78.0±6.3)s]短于DLBT组[(115.0±11.2)s],单肺通气后肺塌陷时间[(331.0±25.0)s]长于DLBT组[(198.0±17.0)s],差异有统计学意义(P<0.01)。SLBT组单肺通气5 min后气道峰压[(19.5±4.2)cm H2O,1 cm H2O=0.098 kPa]低于DLBT组[(27.0±3.7)cm H2O],差异有统计学意义(P<0.01)。SLBT组患者完合清醒拔管后即刻咽痛评分(1.00分)低于DLBT组(2.00分),SLBT组患者完全清醒拔管后即刻及术后24 h声音嘶哑评分(0.50分、0分)低于DLBT组(1.00分、1.00分),差异有统计学意义(P<0.05)。结论SLBT在胸腔镜手术中的插管时间、摆放体位后定位时间、手术视野暴露情况、术中导管移位情况与DLBT基本相当,可降低气道阻力,减轻患者术后咽喉疼痛及声音嘶哑的情况,但其肺塌陷时间偏长。
Objective To evaluate the effects of single-lumen bronchial tube(SLBT)in the anaesthesia of thoracoscopy surgery.Methods A retrospective study was performed on 60 cases of patients who were admitted to and underwent thoracoscopy surgery,such as bullectomy,wedge resection,segmental or lobectomy from January 2020 to October 2020.Anesthesiology department of 970th Hospital of the PLA,including 29 males,31 females,aged(55.2±14.6)years old,ranging from 17 to 87 years old.All patients were randomly divided into the SLBT group and Double-lumen bronchial tube(DLBT)group,with 30 cases in each group.Compare two groups of patients with intubation time and the orientation of after intubation time after putting the position,time,lung collapse after one-lung ventilation time,surgical field exposure,5 minutes after one-lung ventilation airway peak pressure and intraoperative catheter shift number,fully conscious patients with tube drawing immediately,24 hours and 72 hours after surgery,postoperative sore throat and hoarse.Results The post-intubation positioning time in the SLBT group[(78.0±6.3)s]was shorter than that in the DLBT group[(115.0±11.2)s],the time of lung collapse after single lung ventilation in SLBT group[(331.0±25.0)s]was longer than that in DLBT group[(198.0±17.0)s],and the differences were statistically significant(P<0.01).After 5 minutes of one-lung ventilation,the peak airway pressure in SLBT group[(19.5±4.2)cm H2O,1 cm H2O=0.098 kPa]was lower than that in DLBT group[(27.0±3.7)cm H2O],and the difference was statistically significant(P<0.01).The pharyngeal pain score of SLBT group(1.00)was lower than that of DLBT group(2.00),the hoarseness score of SLBT group immediately after extubation and 24 hours after operation(0.50,0)was lower than that of DLBT group(1.00,1.00),and the differences were statistically significant(P<0.05).Conclusion The effects of SLBT in thoracoscopy surgery on intubation time,positioning time after placement of body positioin,intraoperative catheter displacement and surgical field exposure were equivalent to those of DLBT.It can reduce airway resistance,relieve sore throat and hoarseness of postoperative,but the time of pulmonary collapse is a little long.
作者
李集慧
鞠衍馨
刘震
张岩
邹凌燕
Li Jihui;Ju Yanxin;Liu Zhen;Zhang Yan;Zou Lingyan(Department of Anesthesiology,970th Hospital of the PLA,Weihai 264200,China)
出处
《中国临床实用医学》
2021年第2期1-5,共5页
China Clinical Practical Medicine
关键词
麻醉
单腔支气管导管
双腔支气管导管
单肺通气
胸腔镜手术
Anaesthesia
Single-lumen bronchial tube
Double-lumen bronchial tube
One-lung ventilation
Thoracoscopy surgery
