CAJ | 학술논문

目的：探讨3种左侧双腔支气管盲插定位的临床效果。方法105例需要支气管插管全身麻醉的骨科胸廓手术患者，按随机数字表法分为3组，每组35例。气囊压力组使用支气管气囊压力观察法顺行插管进行左支气管插管定位；导管阻力组使用导管阻力法定位；身高预测组根据患者身高预测支气管插管深度进行插管。对比3组首次插管完成肺分隔成功率、首次插管完成肺分隔耗时、导管位置准确率及并发症。结果气囊压力组、导管阻力组、身高预测组首次插管完成肺分隔成功率分别为91．43％、62．86％、65．71％，耗时分别为（103．23±13．02） s、（114．66±26．54） s、（83．57±35．77） s；导管位置定位准确性阳性预测值分别为0．91，0．59，0．65；导管位置准确率气囊压力组明显高于导管阻力组、身高预测组（P＜0．05），但导管阻力组、身高预测组比较，差异无统计学意义（P＞0．05）；3组隆突黏膜出血、声嘶发生率比较，差异无统计学意义（P＞0．05）。结论左支气管气囊压力观察法定位的效果好于导管阻力法和身高预测法。
목적：탐토3충좌측쌍강지기관맹삽정위적림상효과。방법105례수요지기관삽관전신마취적골과흉곽수술환자，안수궤수자표법분위3조，매조35례。기낭압력조사용지기관기낭압력관찰법순행삽관진행좌지기관삽관정위；도관조력조사용도관조역법정위；신고예측조근거환자신고예측지기관삽관심도진행삽관。대비3조수차삽관완성폐분격성공솔、수차삽관완성폐분격모시、도관위치준학솔급병발증。결과기낭압력조、도관조력조、신고예측조수차삽관완성폐분격성공솔분별위91．43％、62．86％、65．71％，모시분별위（103．23±13．02） s、（114．66±26．54） s、（83．57±35．77） s；도관위치정위준학성양성예측치분별위0．91，0．59，0．65；도관위치준학솔기낭압력조명현고우도관조력조、신고예측조（P＜0．05），단도관조력조、신고예측조비교，차이무통계학의의（P＞0．05）；3조륭돌점막출혈、성시발생솔비교，차이무통계학의의（P＞0．05）。결론좌지기관기낭압력관찰법정위적효과호우도관조역법화신고예측법。
Objective To investigate the effects of three blind positioning methods of left-sided double-lumen endo-bronchial tube intubation.Methods One hundred and five patients whose needed general anesthesia with left-sided double-lumen endobronchial intubation in thoracic surgery were enrolled in this study ,they were divided into 3 groups according to the random number table,with 35 cases in each group.The anterogade catheterization was conducted with observation on bronchial balloon pressure to perform left-side endobronchial tube intubation in the balloon pressure group , the catheterization was conducted with the method of tube resistance in the tube resistance group ,and the catheterization was conducted by predicting the depth of endobronchial tube according to the patient′s body height in the body height prediction group .The completed rates and the time consumptions for separate lung in the first attempt ,the accuracy and complications of three groups were compared .Results The completed rates for separate lung of balloon pressure group ,tube resistance group and body height prediction group were 91.43%,62.86%,65.71%,respectively,the time consumptions were (103.23 ±13.02) seconds,(114.66 ±26.54) seconds,(83.57 ±35.77) seconds,respectively.The positive predictive value of accuracy were 0.91,0.59,0.65,respectively .The accuracy of balloon pressure group was significantly higher than that of tube resistance group and body height prediction group (P<0.05),but there was no significant difference in the accuracy between tube resistance group and body height prediction group (P>0.05).The incidences of mucosal bleeding,hoarse showed no significant difference among three groups (P >0.05).Conclusion The effect of visual bronchial balloon pressure method is better than that of tube resistance method and body height prediction for left -sided endobroncial intubation .