国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2011年
7期
771-774
,共4页
双腔支气管%听诊法%呼末二氧化碳监测%纤维支气管镜
雙腔支氣管%聽診法%呼末二氧化碳鑑測%纖維支氣管鏡
쌍강지기관%은진법%호말이양화탄감측%섬유지기관경
Double-lumen tube%Stethoscopy%PETCO2monitoring%Bronchofibroscopy
目的 对比评价用听诊法及呼吸末CO2分压(PETCO2)监测在双腔管检查定位中的临床应用.方法选择择期胸外科手术病人80例,随机分为A组和B组.全麻诱导后插入DLT,A组判断双腔管位置,采用听诊法,B组采用PETCO2以进行判断.两组定位后用纤维支气管镜(FOB)检查定位和调整导管位置.侧卧后再次分别定位并采用FOB检查定位和调整导管位置.判断平、侧卧位DLT对位情况,记录结果.术中所有病人常规予以用PETCO2以进行监测变化.结果 两组病人男女组成比例、左或是右侧支气管内插管等基本情况比较无统计学意义.仰卧位和侧卧位A组定位错位率为47.5%,30.0%,均明显高于B组的20%,7.5%,x2=6.76,5.25,P＜0.05,差异有显著性;右支气管组导管位移率与左支气管组比较(34.2%vs7.1%),x2=7.52,P＜0.01,差异有显著性.错位深度两组比较,右侧支气管组(1.3±0.4)cm明显低于左侧(2.4±1.1)cm,P＜0.01,差异有显著性.结论 B组即采用PETCO2以进行判断双腔管位置比A组(采用听诊法)判断来得精确.导管位移率右侧支气管组发生率高于左侧.
目的 對比評價用聽診法及呼吸末CO2分壓(PETCO2)鑑測在雙腔管檢查定位中的臨床應用.方法選擇擇期胸外科手術病人80例,隨機分為A組和B組.全痳誘導後插入DLT,A組判斷雙腔管位置,採用聽診法,B組採用PETCO2以進行判斷.兩組定位後用纖維支氣管鏡(FOB)檢查定位和調整導管位置.側臥後再次分彆定位併採用FOB檢查定位和調整導管位置.判斷平、側臥位DLT對位情況,記錄結果.術中所有病人常規予以用PETCO2以進行鑑測變化.結果 兩組病人男女組成比例、左或是右側支氣管內插管等基本情況比較無統計學意義.仰臥位和側臥位A組定位錯位率為47.5%,30.0%,均明顯高于B組的20%,7.5%,x2=6.76,5.25,P＜0.05,差異有顯著性;右支氣管組導管位移率與左支氣管組比較(34.2%vs7.1%),x2=7.52,P＜0.01,差異有顯著性.錯位深度兩組比較,右側支氣管組(1.3±0.4)cm明顯低于左側(2.4±1.1)cm,P＜0.01,差異有顯著性.結論 B組即採用PETCO2以進行判斷雙腔管位置比A組(採用聽診法)判斷來得精確.導管位移率右側支氣管組髮生率高于左側.
목적 대비평개용은진법급호흡말CO2분압(PETCO2)감측재쌍강관검사정위중적림상응용.방법선택택기흉외과수술병인80례,수궤분위A조화B조.전마유도후삽입DLT,A조판단쌍강관위치,채용은진법,B조채용PETCO2이진행판단.량조정위후용섬유지기관경(FOB)검사정위화조정도관위치.측와후재차분별정위병채용FOB검사정위화조정도관위치.판단평、측와위DLT대위정황,기록결과.술중소유병인상규여이용PETCO2이진행감측변화.결과 량조병인남녀조성비례、좌혹시우측지기관내삽관등기본정황비교무통계학의의.앙와위화측와위A조정위착위솔위47.5%,30.0%,균명현고우B조적20%,7.5%,x2=6.76,5.25,P＜0.05,차이유현저성;우지기관조도관위이솔여좌지기관조비교(34.2%vs7.1%),x2=7.52,P＜0.01,차이유현저성.착위심도량조비교,우측지기관조(1.3±0.4)cm명현저우좌측(2.4±1.1)cm,P＜0.01,차이유현저성.결론 B조즉채용PETCO2이진행판단쌍강관위치비A조(채용은진법)판단래득정학.도관위이솔우측지기관조발생솔고우좌측.
Objective To assess the clinical use of stethoscopy and PETCO2 monitoring in positioning double-lumen tube ( DLT ) in thoracotomy. Methods Eighty patients undergoing elective chest surgery were randomly devided into group A and group B. After general anesthetic intubation, we judged the positon of DLT in group A by stethoscopy and that in group B by PETCO2 monitoring. All the positions of DLTs were double-checked and adjusted by bronchofibroscopy. On lateral position, we repeated the same procedure. The judged placement of DLT on dorsal and lateral position was recorded. All the patients were monitored the changes in PETCO2 during the surgery.Results The male to femal ratio and right- or left- sided DLT placement did not differ significantly. On two positions, the malposition frequency was obviously higher in group A than in group B ( x2= 6.76 and 5.25, P＜ 0.05 ＝; the frequency of displacement of DLT from the right bronchus was higher than that from the left bronchus ( x2=7.52, P＜0.01 ＝ and the depth of displacement from the right bronchus was smaller than the left bronchus ( P＜ 0.01 ＝. Conclusions PETCO2 monitoring is more accurate than stethoscopy in positioning double-lumen tube. The rate of DLT displacemnt from the right bronchus is higher than that from the left bronchus.
