纤维支气管镜引导下双腔支气管导管插管在胸外科手术麻醉中的应用

目的探讨纤维支气管镜引导下行双腔支气管导管插管定位的可行性。方法将60例在全身麻醉下经左侧支气管插管行胸外科手术的患者随机分为2组:传统听诊组(n=30)及纤维支气管镜组(n=30),传统听诊组患者使用传统听诊法插管后,用纤维支气管镜精确定位;纤维支气管镜组患者在纤维支气管镜引导下行双腔支气管导管插管。记录两组患者双腔支气管导管准确定位的病例数以及定位所需时间;观察患者不同时间的心率,平均动脉压。结果传统听诊组患者准确定位17例(56.7%),13例(43.3%)需在纤维支气管镜协助下进一步调整位置。纤维支气管镜组29例患者准确定位。传统听诊组、纤维支气管镜组患者的平均定位所需时间分别为(82.2±31.9)s、(63.5±19.4)s,二者比较,差异有统计学意义(P<0.01)。两组患者心率、平均动脉压在各时点的差异无统计学意义。结论纤维支气管镜引导下双腔支气管导管插管定位可提高双腔支气管导管准确定位的成功率,减少定位所需时间。

Application of fiberoptic bronchoscopy-guided double-lumen endobronchial tube placement in thoracic surgery anesthesia

Objective To explore the feasibility of fiberoptic bronchoscopy-guided double-lumen endobronchial tube placement.Methods 60 patients who accepted thoracic surgical procedures with the left bronchial intubation and general anesthesia were randomly divided into 2 groups: conventional auscultation group(n=30) and fiberoptic bronchoscopy group(n=30).Patients in conventional auscultation group were subjected bronchial intubation using conventional auscultation,followed by precise positioning using fiberoptic bronchoscopy,while patients in fiberoptic bronchoscopy group accepted fiberoptic bronchoscopy-guided double-lumen endobronchial tube placement.The case number and duration of precise positioning using fiberoptic bronchoscopy of patients in 2 groups were recorded.Heart rate and mean arterial pressure of patients at different time points were observed.Results Precise positioning were performed in 17 patients(56.7%) in conventional auscultation group,13 patients(43.3%) needed assistance of fiberoptic bronchoscopy for further position adjustment.While in fiberoptic bronchoscopy group precise positioning were founded in 29 patients.The mean duration of precise positioning of patients in conventional auscultation group and fiberoptic bronchoscopy group were(82.2±31.9)s and(63.5±19.4)s,respectively,which showed significant difference between them(P<0.01).No significant difference was found in heart rate and mean arterial pressure of patients in the two groups at each time point.Conclusion Fiberoptic bronchoscopy-guided double-lumen endobronchial tube placement may improve the success rate of precise positioning of double-lumen endobronchial tube,and reduce the duration of positioning.