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| 帝视内窥镜在Univent管插管与定位中的临床应用 |
| Clinical application of Disposcope endoscope in Univent tube intubation and positioning |
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| DOI： |
| 中文关键词: 帝视内窥镜 Univent管 插管 定位 |
| 英文关键词: Disposcope endoscop Univent tube Intubation Positioning |
| 基金项目:山西省科技攻关项目(20150313009-2) |
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| 中文摘要: |
目的：观察帝视内窥镜在Univent管插管及定位中的临床应用效果。
方法：选择胸科手术患者80例,性别不限，年龄18～77岁，ASA Ⅰ～Ⅲ级。使用Univent管进行单肺通气, 随机分为帝视内窥镜组(D组)和喉镜组(L组), 每组40例。D组使用帝视内窥镜进行插管和定位, L组使用喉镜插管并用听诊法定位。记录插管时间、双肺通气和单肺通气时的气道峰压、PaCO2及肺塌陷情况, 并计算插管一次成功率、封堵器调整定位的比例以及插管并发症发生率。
结果：L组所用插管时间(169.98±52.65)s明显长于D组(102.38±44.45)s(P<0.05),L组插管一次成功率（80%）明显低于D组(97.5%)(P<0.05)。两组双肺通气和单肺通气时的气道峰压、PaCO2及肺塌陷情况差异无统计学意义。L组调整封堵器的比例（22.5%）明显高于D组(7.5%)(P<0.05)。L组导管染血的发生率（27.5%）明显高于D组（7.5%）（P<0.05），术后咽痛的发生率（37.5%）明显高于D组（15.0%）（P<0.05）。
结论：与喉镜插管并用听诊法定位比较, 帝视内窥镜用于Univent管插管与定位, 操作所需时间较短, 成功率高,定位准确率高, 且并发症较少。 |
| 英文摘要: |
Objective: To observe the clinical application effects of Disposcope endoscope in Univent tube intubation and positioning.
Methods: Eighty patients underwent scheduled thoracic surgery (51 males, 29 females, aged 18-77 years, ASA Ⅰ-Ⅲ) under one-lung ventilation (OLV) were randomly grouped into two groups: Disposcope endoscope group (group D) and laryngoscope group (group L), 40 patients in each group. Group D used Disposcope endoscope for intubation and positioning while group L used laryngoscope for intubation and auscultation positioning. Patients with difficult intubation, severe ventilation dysfunction and large sputum volume, such as pulmonary hemoptysis and bronchiectasis, were excluded. Intubation and positioning time, airway pressure and arterial carbon dioxide partial pressure (PaCO2) were recorded during double-lung ventilation and OLV, lung collapse effect, and one-time successful intubation ratio, positionging adjustment ratio and the incidence of intubation complications were calculated.
Results: Intubation and positioning time were significantly longer in group L than in group D [(169.98±52.65)s vs. (102.38±44.45)s](P<0.05), one-time successful intubation ratio in group L was lower than that in group D (80% vs. 97.5%) (P<0.05). The difference of airway pressure and PaCO2 during double-lung ventilation and OLV between the two groups were not statistically significant. The blocker positioning adjust ratio of Univent tube in group L was significantly higher than that in group D (22.5% vs. 7.5%)(P<0.05). The incidence of bleeding and sore throat after operation in group L were significantly higher than those in group D (27.5% vs. 7.5%, 37.5% vs. 15%)(P<0.05).
Conclusion: Compare with laryngoscope for intubation and auscultation positioning, Disposcope endoscope used for Univent tube intubation and positioning needs shorter time for intubation and positioning, higher successful one-time intubation ratio, less positioning adjustment. It also reduces the incidence of intubation complications. |
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