【摘要】 目的评估胸科行右侧肺叶单肺通气手术时,支气管封堵器应用的可行性及安全性。方法收集术中需要行右侧肺叶单肺通气的择期胸科手术患者36例,随机分为A、B两组,每组18例,A组插管方法采用传统双腔支气管法,B组采用支气管封堵器法。通过观察插管时间、插管前后生命体征变化、术中肺萎陷的质量、记录插管后、单肺通气20、40、60 min酸碱度(p H)、氧分压(p O2)、二氧化碳分压(p CO2)、及气道压Paw、患者术中出现低氧血症的例数及术后并发症等指标比较两种方法的安全性。结果单肺通气后所有患者Paw均升高,但随着时间的延长,B组明显低于A组(P<0.05);B术中发生低氧血症及术后发生声音嘶哑等并发症的例数均明显降低(P<0.05),差异有统计学意义。结论在行右侧肺叶单肺通气的胸科手术中,支气管封堵器法可以解决术中因双腔支气管对位不良而导致术中患者血氧降低的问题,且对气道刺激较小,是一种安全、有效的单肺通气方法。更多还原

【Abstract】 Objective To evaluate the safety and feasibility of the application of bronchial occluder in the right lobe one- lung ventilation in thoracic surgery. Methods From July 2012 to August 2013, 36 consecutive patients who need the right lobe one-lung ventilation in thoracic surgery were enrolled and were randomly divided into two groups: group A and group B, 18 cases in each group. The traditional double lumen bronchial method was used in group A and the bronchial occluder was used in group B intubation time.Changes of vital signsbefore and after intubation,the qualityof lung collapse during operation, p H, arterial partial pressure of CO2, partial pressure of oxygen and airway pressure Paw were recorded 20 min, 40 min,and60 min after intubation or one- lung ventilation. The number of patients with hypoxia in the operation and postoperative complications in each group were also recorded. Results The airway pressure in group B was significantly lower than that in group A, and the number of patients with postoperative complications such as hypoxia and postoperative hoarseness was significantly lower(P<0.05). Conclusion Bronchialoccluder method could solve intraoperative blood oxygen desaturation caused by the double lumen endobronchial malalignment, and airway irritation was mild. Consequently,it is a safe and effective method for single lung ventilation in the right lobe one-lung ventilation in thoracic surgery.更多还原