CAJ | 학술논문

目的评价Coopdech封堵支气管导管联合加强型气管导管用于上纵隔肿瘤切除术患者气道管理的效果.方法拟经前外侧开胸行上纵隔肿瘤切除术患者22例,年龄24～66岁,体重48～78 kg,ASA分级Ⅱ或Ⅲ级,采用随机数字表法,将患者随机分为双腔支气管导管组(Ⅰ组)和Coopdech封堵支气管导管联合加强型气管导管组(Ⅱ组),每组11例.Ⅰ组术中采用双腔支气管导管技术行单肺通气;Ⅱ组采用Coopdech封堵支气管导管联合加强型气管导管进行气道管理,需单肺通气时可应用Coopdech封堵支气管导管进行肺隔离.两组均应用纤维支气管镜辅助气管内导管定位.记录气管插管时间、定位时间、导管移位情况、纤维支气管镜检查次数、气道峰压增加情况、肺萎陷程度、术后咽痛声嘶的发生情况、呼吸机辅助通气情况.结果与Ⅰ组比较,Ⅱ组气管插管时间缩短,导管移位的发生率、气道峰压增加率和术后咽痛声嘶发生率降低(P＜0.05或0.01),定位时间、纤维支气管镜检查次数、肺萎陷程度及术后呼吸机辅助通气发生率差异无统计学意义(P＞0.05).结论 Coopdech封堵支气管导管联合加强型气管导管用于前外侧开胸行上纵隔肿瘤切除术患者气道管理的效果优于双腔支气管导管.
목적 평개Coopdech봉도지기관도관연합가강형기관도관용우상종격종류절제술환자기도관리적효과.방법 의경전외측개흉행상종격종류절제술환자22례,년령24～66세,체중48～78 kg,ASA분급Ⅱ혹Ⅲ급,채용수궤수자표법,장환자수궤분위쌍강지기관도관조(Ⅰ조)화Coopdech봉도지기관도관연합가강형기관도관조(Ⅱ조),매조11례.Ⅰ조술중채용쌍강지기관도관기술행단폐통기;Ⅱ조채용Coopdech봉도지기관도관연합가강형기관도관진행기도관리,수단폐통기시가응용Coopdech봉도지기관도관진행폐격리.량조균응용섬유지기관경보조기관내도관정위.기록기관삽관시간、정위시간、도관이위정황、섬유지기관경검사차수、기도봉압증가정황、폐위함정도、술후인통성시적발생정황、호흡궤보조통기정황.결과 여Ⅰ조비교,Ⅱ조기관삽관시간축단,도관이위적발생솔、기도봉압증가솔화술후인통성시발생솔강저(P＜0.05혹0.01),정위시간、섬유지기관경검사차수、폐위함정도급술후호흡궤보조통기발생솔차이무통계학의의(P＞0.05).결론 Coopdech봉도지기관도관연합가강형기관도관용우전외측개흉행상종격종류절제술환자기도관리적효과우우쌍강지기관도관.
Objective To evaluate the efficacy of Coopdech bronchial blocker combined with a strengthened single-lumen tube for airway management in patients undergoing upper mediastinal tumor resection. Methods Twenty-two ASA Ⅱ or Ⅲ patients, aged 24-66 yr, weighing 48-78 kg, scheduled for elective resection of upper mediastinal tumor, were randomly divided into 2 groups (n=11 each):double-lumen tube group(groupⅠ) and Coopdech bronchial blocker combined with a strengthened single-lumen tube group(group Ⅱ).One-lung ventilation was achieved with a double-lumen tube in groupⅠ. The Coopdech bronchial blocker combined with a strengthened single-lumen tube was used for airway management and the Coopdech bronchial blocker was used for lung isolation when one-lung ventilation was required in group Ⅱ. The fiberoptic bronchoscope was used to assist endotracheal tube positioning in both groups. The intubation time, positioning time, the number of patients required for tube displacement, the number of fiberoptic bronchoscopy, increase in airway peak pressure, degree of lung collapse, postoperative sore throat and hoarseness, and the number of patients needing ventilator-assisted ventilation were recorded. Results The intubation time was significantly shorter, the number of patients required for tube displacement was significantly smaller,and the rate of increase in airway peak pressure and incidences ofpostoperative sore throat and hoarseness were significantly lower in group Ⅱ than in group Ⅰ (P＜0.05 or0.01). Conclusion The efficacy of the Coopdech bronchial blocker combined with a strengthened single-lumen tube for airway management is better in patients undergoing upper mediastinal tumor resection than the double-lumen tube.