摘要
目的探讨支气管封堵器(BB)定位在单肺通气(OLV)手术患者中的应用效果。方法选取OLV手术患者166例,按照定位方法的不同分为观察组[气道峰压(P_(peak))差值变化定位]81例和对照组(纤维支气管镜定位)85例,比较2组定位效果。结果观察组定位成功率、插管时间与对照组比较,差异均无统计学意义(P>0.05);观察组定位时间短于对照组,不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。在确认套囊位置正确行双肺通气(T_(1))、确认套囊位置正确行OLV(T_(2))、套囊插入到支气管深处呈置管过深状态行OLV(T_(3))、套囊退回到支气管开口处呈置管偏浅状态行OLV(T_(4))时,观察组P_(peak)、平台压(P_(plat))低于对照组,肺顺应性(C_(dyn))高于对照组,差异有统计学意义(P<0.05)。T_(3)时,观察组平均动脉压(MAP)、心率(HR)低于对照组,血氧饱和度(SpO_(2))高于对照组,差异有统计学意义(P<0.05)。结论与纤维支气管定位比较,BB定位应用于OLV手术患者能够使定位更快、安全性更高,可有效减少应激反应。
Objective To explore the effect of bronchial blocker(BB)positioning in patients undergoing one-lung ventilation(OLV).Method A total of 166 OLV patients were selected and divided into observation group[positioning of the change of peak airway pressure(P_(peak))difference,n=81]and control group(positioning of fiberoptic bronchoscopy,n=85)according to different positioning methods.The positioning effects of the two groups were compared.Results There were no significant differences in the success rate of positioning and intubation time between the observation group and the control group(P>0.05).The positioning time was shorter and total incidence of adverse reactions in the observation group were significantly lower than those in the control group(P<0.05).At the time points of undergoing double lung ventilation after confirming the correct position of the cuff(T_(1)),undergoing OLV after confirming the correct position of the cuff(T_(2)),undergoing OLV when the cuff was inserted into deep position of the bronchus(T_(3)),and undergoing OLV when the cuff returned to the opening of the bronchus in the shallow position of the tube(T_(4)),P_(peak) and plateau pressure(P_(plat))of the observation group were significantly lower,and dynamic Compliance(C_(dyn))was significantly higher than that of the control group(P<0.05).At T_(3),mean arterial pressure(MAP)and heart rate(HR)of the observation group were significantly lower,and the oxygen saturation(SpO_(2))was significantly higher than that of the control group(P<0.05).Conclusion Compared with fibrobronchial positioning,BB positioning can be applied in OLV patients with faster positioning and higher safety,which can effectively reduce stress response.
作者
张帮健
韩清涛
刘义鑫
杨昶
ZHANG Bangjian;HAN Qingtao;LIU Yixin;YANG Chang(Department of Anesthesiology,Panzhihua Central Hospital in Sichuan Province,Panzhihua,Sichuan,617000)
出处
《实用临床医药杂志》
CAS
2021年第18期34-37,共4页
Journal of Clinical Medicine in Practice
基金
四川省攀枝花市中心医院院内科研项目(201906)。
关键词
气道峰压差值变化
支气管封堵器
定位
单肺通气
应激反应
change of peak airway pressure difference
bronchial blocker
positioning
one-lung ventilation
stress response
