纤维支气管镜评价常规双腔支气管导管插管定位的准确性

目的 应用纤维支气管镜评价常规双腔支气管导管插管定位的准确性.方法 110例行肺癌手术患者在麻醉诱导完全后,行双腔支气管插管,采用听诊法调整导管位置,判断双腔管的就位情况.在双腔管就位满意后,再以纤支镜下的准确定位判定双腔支气管的位置.结果 63例左侧双腔支气管插管中,经听诊法检查满意的有46例(73%)仍有17例(27%)经纤维支气管镜确诊为定位不准确;47例右侧双腔支气管插管中,经听诊法检查满意的有32例(68%),仍有15例(32%)经纤维支气管镜确诊为定位不准确,经纤支镜调整均达到准确定位.结论 双腔支气管导管插管病人,听诊法定位准确的病人中,仍有35%(左)和44%(右)假阳性,需要纤支镜确诊重新定位.

Evaluation on Accuracy Position of Double-lumen Tube Intubation with fibreoptic bronchoscopy

Objective To evaluate the accuracy of positionning double-lumen tube (DLT) intubation with fibreoptic bronchoscopy. Methods 110 cases of patients with lung cancer for operation were inserted DLT after anesthesia induction. The position of DLT was adjusted via auscultation first. After getting satisfactory location, Judged the accuracy of DLT with fibreoptic bronchoscopy again. Results There were 46 cases (73%) obtained satisfactory location, 17 cases (27%) unsatisfactory in 63 cases of the left DLT. There were 32 cases (68%) obtained satisfactory location, 15 cases (32%) unsatisfactory in 47 cases of the right DLT. But all of DLT were adjusted to correct position under fibreoptic bronchoscopy. Conclusion There still were 35% patients (Left DLT) and 44% (Right DLT ) to be false positive in the patients who obtained correct position via auscultation. These patients need repositionning with fibreoptic bronchoscopy.