单腔气管导管用于儿童单肺通气的临床应用观察

通过观察单腔气管导管用于儿童单肺通气（OLV）的应用,探讨其在临床应用的安全性。方法：随机选取14例行胸科手术患儿,全麻诱导气管插管后,将单腔气管导管在纤维支气管镜（φ：2.8mm）引导下置入健侧主支气管,并经听诊后确定封堵效果。观察单肺通气前（T1）,单肺通气5mim后（T2）,单肺通气结束前（T3）,单肺通气结束后（T4）的心率HR、血压BP、Sp O2、动脉血气分析、气道压力（PAW）变化。结果：左侧单肺通气5例,右侧单肺通气9例,单肺通气时间40~210mim。全组病例Pa O2：T2较T1明显下降（204±102.2）,T3持续小幅下降（202.9±112.3）;T4基本恢复至单肺通气前水平（393.6±88.3）。Pa CO2：T2上升（36±4.8）,T3持续升高（39.6±5.2）,T4降至术前水平（36±5.1）;PAW：T2升高（22±2.9）,T3维持较高水平（21.4±2.3）,T4恢复术前水平（17.9±1.9）。全组病例p H值各时间点数据无明显变化。结论：单腔气管导管能够安全的用于儿童的单肺通气。

Clinical Observation of Single lumen endotracheal tube used for children with single lung ventilation

by observing the single lumen endotracheal tube application of one-lung ventilation （OLV） in children and its safety in clinical application. Methods： randomly selected 14 children with routine thoracic surgery, after endotracheal intubation of general anesthesia induction, the single lumen endotraeheal tube in fiber broncho- scope （φ ：2.8 mm） guided into the contralateral primary bronchus, and determine the effect after auscultation. One-lung ventilation （T1）, before the observation after 5 mira one-lung ventilation （T2）, before the end of single lung single lung ventilation, 40-210 mim one-lung ventilation time. Incidence PaO2：T2 T1 significantly lower （204 ±102.2）, a slight drop in T3 last （202.9 ± 112.3）; T4 one-lung ventilation before back to basic level （393.6 ± 88.3）. Pa- CO2：T2 rise （36 ± 4.8）, increasing T3（39.6 ±5.2）, the T4 to preoperative levels （36 ± 5.1）; Paw： T2 （22 ±2.9）, T3 to maintain higher levels （21.4±2.3）, T4 resume preoperative levels （17.9 ± 1.9）. Incidence of pH： each time point data have no obvious changes. Conclusion： single lumen endotracheal tube can be safe for children over the age of 1 with single lung ventilation