甘肃医药
甘肅醫藥
감숙의약
Gansu Medical Journal
2015年
8期
570-572
,共3页
Coopdech支气管封堵器%选择性肺叶隔离通气%双腔支气管导管
Coopdech支氣管封堵器%選擇性肺葉隔離通氣%雙腔支氣管導管
Coopdech지기관봉도기%선택성폐협격리통기%쌍강지기관도관
Coopdech endobronchial blocker tube%selective lobar blockade ventilation%double lumen tube
目的：评价Coopdech支气管封堵器在开胸手术中对选择性肺叶隔离病人通气效果的影响。方法：择期行VATS右肺中或下叶部分切除术病人40例，随机分为双腔支气管导管组（V组）和Coopdech支气管封堵器组（C组）。 V组：选择合适型号的双腔支气管导管行单肺通气。C组：经口插入单腔气管导管，然后将润滑后的Coopdech支气管封堵器置入单腔气管导管中；使用小儿纤维支气管镜定位，将Coopdech支气管封堵器置入右中间支气管开口内约0.5cm，使套囊位于右上肺叶支气管开口下，行左侧肺叶和右肺上叶通气。于麻醉诱导后（T0）、OLV/左肺和右上肺叶通气后20min（T1）、OLV/左肺和右上肺叶通气后60min（T2）、恢复TLV10min（T3）采桡动脉血3ml做血气分析，记录PaO2、PaCO2及气道平台压，气道峰压。结果：与V组比较，C组病人T1，2时PaO2升高，气道峰压及气道平台压下降（P<0.05），两组间及组内PaCO2均无统计学差异。结论：Coopdech支气管封堵器在选择性肺叶隔离通气时可精确合理控制肺叶隔离；改善氧合、降低气道压。
目的：評價Coopdech支氣管封堵器在開胸手術中對選擇性肺葉隔離病人通氣效果的影響。方法：擇期行VATS右肺中或下葉部分切除術病人40例，隨機分為雙腔支氣管導管組（V組）和Coopdech支氣管封堵器組（C組）。 V組：選擇閤適型號的雙腔支氣管導管行單肺通氣。C組：經口插入單腔氣管導管，然後將潤滑後的Coopdech支氣管封堵器置入單腔氣管導管中；使用小兒纖維支氣管鏡定位，將Coopdech支氣管封堵器置入右中間支氣管開口內約0.5cm，使套囊位于右上肺葉支氣管開口下，行左側肺葉和右肺上葉通氣。于痳醉誘導後（T0）、OLV/左肺和右上肺葉通氣後20min（T1）、OLV/左肺和右上肺葉通氣後60min（T2）、恢複TLV10min（T3）採橈動脈血3ml做血氣分析，記錄PaO2、PaCO2及氣道平檯壓，氣道峰壓。結果：與V組比較，C組病人T1，2時PaO2升高，氣道峰壓及氣道平檯壓下降（P<0.05），兩組間及組內PaCO2均無統計學差異。結論：Coopdech支氣管封堵器在選擇性肺葉隔離通氣時可精確閤理控製肺葉隔離；改善氧閤、降低氣道壓。
목적：평개Coopdech지기관봉도기재개흉수술중대선택성폐협격리병인통기효과적영향。방법：택기행VATS우폐중혹하협부분절제술병인40례，수궤분위쌍강지기관도관조（V조）화Coopdech지기관봉도기조（C조）。 V조：선택합괄형호적쌍강지기관도관행단폐통기。C조：경구삽입단강기관도관，연후장윤활후적Coopdech지기관봉도기치입단강기관도관중；사용소인섬유지기관경정위，장Coopdech지기관봉도기치입우중간지기관개구내약0.5cm，사투낭위우우상폐협지기관개구하，행좌측폐협화우폐상협통기。우마취유도후（T0）、OLV/좌폐화우상폐협통기후20min（T1）、OLV/좌폐화우상폐협통기후60min（T2）、회복TLV10min（T3）채뇨동맥혈3ml주혈기분석，기록PaO2、PaCO2급기도평태압，기도봉압。결과：여V조비교，C조병인T1，2시PaO2승고，기도봉압급기도평태압하강（P<0.05），량조간급조내PaCO2균무통계학차이。결론：Coopdech지기관봉도기재선택성폐협격리통기시가정학합리공제폐협격리；개선양합、강저기도압。
Objective:To evaluate the effect of Coopdech endobronchial blocker tube on blood gas concentration in the selective lobar blockade patients with ventilation. Methods:Forty patients undergoing right-sided lung resection VATS were randomly divided into double lumen endobronchial tube group (group V,n=20) in which double lumen endobronchial tube was performed for one lung ventilation,and Coopdech endobronchial blocker tube group (group C,n=20) in which the single lumen endotracheal tube and then Coopdech endobronchial blocker tube were performed for the left lung and right upper lobe of lung ventilation. Blood samples were taken from radial artery for determination of the blood gas. Results: Compared with group V, PaO2 at T1,T2 were increased in group C in which there was significant difference (P<0.05). Compared with group V ,the peak airway pressure and platforms airway pressure were reduced in which there were significant difference (P<0.05). Conclusion:Coopdech endobronchial blocker tube can improve ventilation efficiency and lung protective effect,and can improve oxygenation and reduce the airway pressure.
