中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
21期
1651-1653
,共3页
Coopdech支气管封堵器%双腔支气管导管%儿童%单肺通气
Coopdech支氣管封堵器%雙腔支氣管導管%兒童%單肺通氣
Coopdech지기관봉도기%쌍강지기관도관%인동%단폐통기
Coopdech bronchial blocker%Double-lumen tube%Children%One lung ventilation
目的:比较Coopdech 支气管封堵器与双腔支气管导管在儿童单肺通气中的应用。方法选择中山大学附属汕头医院麻醉科2012年1月至2013年6月40例择期单肺通气行胸外科手术的患儿,经医院伦理委员会审核批准,按随机数字表法分为Coopdech支气管封堵器组( A组,n=20)和双腔支气管导管组(B组,n=20),两组患儿分别通过Coopdech 支气管封堵器和双腔支气管导管实现单肺通气。记录两组患儿插管时间、插管成功率、术侧肺萎陷优良率和术后喉痛声嘶发生率,记录两组患儿单肺通气前后动脉二氧化碳分压(PaCO2)、动脉氧分压(PaO2)和气道压(PAW)的变化。结果 A组插管时间明显长于B组[(224±72)比(165±46)s,P<0.05],A组插管成功率(100%比85%,P<0.05)、术侧肺萎陷优良率明显高于B组(95%比75%,P<0.05),A组术后喉痛声嘶发生率明显低于B组(10%比35%,P<0.05);单肺通气30 min后A组PaO2明显高于B组[(206±58)比(148±63) mmHg,1 mmHg=0.133 kPa,P<0.05],PaCO2和PAW明显低于B组[(36±4)比(45±7) mmHg;(21.6±3.2)比(29.3±5.5) cmH2 O,P<0.05]。结论 Coopdech支气管封堵器与双腔支气管导管均可用于儿童单肺通气,但支气管封堵器具有咽喉损伤较小、插管成功率较高、术野暴露较满意、气道压力低、氧合较充分的优势。
目的:比較Coopdech 支氣管封堵器與雙腔支氣管導管在兒童單肺通氣中的應用。方法選擇中山大學附屬汕頭醫院痳醉科2012年1月至2013年6月40例擇期單肺通氣行胸外科手術的患兒,經醫院倫理委員會審覈批準,按隨機數字錶法分為Coopdech支氣管封堵器組( A組,n=20)和雙腔支氣管導管組(B組,n=20),兩組患兒分彆通過Coopdech 支氣管封堵器和雙腔支氣管導管實現單肺通氣。記錄兩組患兒插管時間、插管成功率、術側肺萎陷優良率和術後喉痛聲嘶髮生率,記錄兩組患兒單肺通氣前後動脈二氧化碳分壓(PaCO2)、動脈氧分壓(PaO2)和氣道壓(PAW)的變化。結果 A組插管時間明顯長于B組[(224±72)比(165±46)s,P<0.05],A組插管成功率(100%比85%,P<0.05)、術側肺萎陷優良率明顯高于B組(95%比75%,P<0.05),A組術後喉痛聲嘶髮生率明顯低于B組(10%比35%,P<0.05);單肺通氣30 min後A組PaO2明顯高于B組[(206±58)比(148±63) mmHg,1 mmHg=0.133 kPa,P<0.05],PaCO2和PAW明顯低于B組[(36±4)比(45±7) mmHg;(21.6±3.2)比(29.3±5.5) cmH2 O,P<0.05]。結論 Coopdech支氣管封堵器與雙腔支氣管導管均可用于兒童單肺通氣,但支氣管封堵器具有嚥喉損傷較小、插管成功率較高、術野暴露較滿意、氣道壓力低、氧閤較充分的優勢。
목적:비교Coopdech 지기관봉도기여쌍강지기관도관재인동단폐통기중적응용。방법선택중산대학부속산두의원마취과2012년1월지2013년6월40례택기단폐통기행흉외과수술적환인,경의원윤리위원회심핵비준,안수궤수자표법분위Coopdech지기관봉도기조( A조,n=20)화쌍강지기관도관조(B조,n=20),량조환인분별통과Coopdech 지기관봉도기화쌍강지기관도관실현단폐통기。기록량조환인삽관시간、삽관성공솔、술측폐위함우량솔화술후후통성시발생솔,기록량조환인단폐통기전후동맥이양화탄분압(PaCO2)、동맥양분압(PaO2)화기도압(PAW)적변화。결과 A조삽관시간명현장우B조[(224±72)비(165±46)s,P<0.05],A조삽관성공솔(100%비85%,P<0.05)、술측폐위함우량솔명현고우B조(95%비75%,P<0.05),A조술후후통성시발생솔명현저우B조(10%비35%,P<0.05);단폐통기30 min후A조PaO2명현고우B조[(206±58)비(148±63) mmHg,1 mmHg=0.133 kPa,P<0.05],PaCO2화PAW명현저우B조[(36±4)비(45±7) mmHg;(21.6±3.2)비(29.3±5.5) cmH2 O,P<0.05]。결론 Coopdech지기관봉도기여쌍강지기관도관균가용우인동단폐통기,단지기관봉도기구유인후손상교소、삽관성공솔교고、술야폭로교만의、기도압력저、양합교충분적우세。
Objective To compare the application of Coopdech bronchial blocker and double lumen bronchial tube during one lung ventilation in children.Methods Forty children undergoing one lung ventilation for thoracic surgery at Shantou Central Hospital from January 2012 to June 2013, approved by hospital ethics committee,were randomized into Coopdech bronchial blocker group (group A) and double-lumen tube group ( group B ).Anesthetic management and lung isolation were performed according to a standardized protocol.Two groups of children with the intubation time ,intubation success rate ,collapse score , the frequency of postoperative hoarseness were recorded.Before and after one lung ventilation in patients of the two groups of PaCO 2 , PaO2 and airway pressure ( PAW ) changes were recorded.Results The intubation time in A was longer than those of group B ((224 ±72)vs(165 ±46) s,P<0.05), the success rate of intubation(100%vs 85%,P<0.05),collapse score in A group was higher than in group B (95%vs 75%,P<0.05 ) , Sore throat hoarseness occurred after operation in A group was lower than in B group (10%vs 35%,P<0.05),PaO2 was higher in group A after one lung ventilation for 30 min ((206 ±58)vs (148 ±63) mmHg,P<0.05), PaCO2 and PAW were lower than group B ((36 ±4)vs(45 ±7) mmHg;(21.6 ±3.2)vs(29.3 ±5.5) cmH2O,P<0.05).Conclusion The Coodech bronchial blocker provided effective surgical exposure with less throat injuries ,higher intubation success rate ,lower airway pressure in children during video-assisted thoracoscopic surgery.