体位变动后纤支镜下对双腔支气管插管的定位

目的研究体位变动后对双腔气管导管位置的影响。方法择期开胸手术患者120例,ASAⅠ或Ⅱ级随机分为两组(n=60)左双腔气管组(L-DLT组)和右双腔支气管组(R-DLT组)。全麻诱导后分别插入左右双腔气管导管,分别以听诊法和纤支镜(FOB)检查法判断双腔管的位置。患者体位改为侧卧后再以听诊法和纤支镜(FOB)检查法判断双腔管的位置。记录各次管的位置深度。结果体位变动后L-DLT组的DLT深度均有改变(P<0.05)移位12例。R-DLT组的DLT深度均有改变(P<0.05)移位18例。25%患者侧卧后导管位置有移位,以向近侧移位居多。位移率R-DLT组均高于L-DLT组(P<0.05)。结论双腔管插管后体位变动,用纤支镜确定和调整双腔管的位置更确切,宜常规使用。

Positioning of Double Lumen Bronchial Tube with Fiberoptic Bronchoscope in Changing Body Position

Objective To study the effect of change body position on the positioning of double lumen bronchial tube.Methods 120 ASAⅠor Ⅱ patients undergoing thoracie surgery were radomly allocated into 2 groups（n=60 each）： left DLT group and right DLT group.double lumen bronchial tube was inserted after induction of anesthesia.Proper position of double lumen rube（DLT） was detemained by fiberoptic bronchoscope and auscultation in supine position and lateral positioning.The depth of the tube inserted was recorded.Results Positioning of double lumen bronchial tube was changed in changing body position.The fiberoptic bronehoscopy revealed that displacement of left DLT was 12 and right DLT was 18.The dislodgement of DLT in lateral positioning of the patient occurred in 25%patients and most case the DLT was moved upward.DLT digplacement especially right DLT occurs quite frquently Conclusion The correct position of DLT should be confirmed and adjusted by FOB when patient is placed in the lateral position before operation.FOB should be used routinely.