|
| CT测量联合视频软镜引导对国产右侧双腔支气管导管定位的影响 |
| Effect of CT measurement combined with flexible video bronchoscope guidance on localization of domestic right-sided double-lumen tube |
| |
| DOI：10.12089/jca.2023.10.006 |
| 中文关键词: 计算机断层扫描 视频软镜 双腔支气管导管 单肺通气 |
| 英文关键词: Computed tomography Flexible video bronchoscope Right-sided double-lumen tube One-lung ventilation |
| 基金项目:苏州市金鸡湖卫生人才项目（苏园社党字〔2021〕11号）；苏州市医工结合协同创新研究项目（SZM2022018） |
|
| 摘要点击次数: 555 |
| 全文下载次数: 333 |
| 中文摘要: |
目的 探讨CT测量联合视频软镜引导技术对国产右侧双腔支气管导管定位的影响。
方法 选择全麻下行胸腔镜左侧肺癌根治术患者95例，男42例，女53例，年龄18～64岁，BMI 18.4~30.5 kg/m2，ASAⅠ—Ⅲ级。采用随机数字表法将患者随机分为两组：传统组（n=48）和联合组（n=47）。传统组采用传统纤维支气管镜引导定位。联合组术前采用螺旋CT测量右主支气管长度（RMB-L）和前后径，根据RMB-L与支气管套囊长度（13 mm）的差值在导管外壁上做一水平线和中垂线，在视频软镜的引导下，水平线与气管隆突平齐，中垂线与气管隆突的中点平齐。记录右侧双腔支气管导管准确定位（最佳和可接受位置）的情况和插管时间。记录术中一过性低氧血症、气道高压、气道损伤分级、术后咽喉痛等不良事件的发生情况。
结果 与传统组比较，联合组右侧双腔支气管导管准确定位率明显升高，插管时间明显缩短，一过性低氧血症、气道高压、气道损伤分级和术后咽喉痛发生率均明显降低（P＜0.05）。
结论 CT测量联合视频软镜的定位方法优于传统纤维支气管镜定位，可提高右侧双腔支气管导管定位准确率，缩短插管时间，减少不良事件的发生。 |
| 英文摘要: |
Objective To investigate the effect of computed tomography (CT) measurements combined with flexible video brouchoscope guidance techniques on the localization of domestic right-sided double-lumen tube (RDLT).
Methods Ninty-five patients, 42 males and 53 females, aged 18-64 years, BMI 18.4-30.5 kg/m2, ASA physical status Ⅰ-Ⅲ, undergoing thoracoscopic radical resection of left lung cancer under general anesthesia were selected. The patients were randomly divided into two groups: traditional group (n = 48) and combination group (n = 47). The traditional group adopted traditional fiberoptic bronchoscope guided technique. In the combined group, the right main bronchus length (CNP-L) and anterior-posterior diameter were measured by spiral CT before operation, a horizontal line and a midvertical line were drawn on the outer wall of the catheter according to the difference between CNP-L and bronchial sleeve length (13 mm). Under the guidance of the video soft mirror, the horizontal line is flush with the tracheal bulge, and the middle vertical line is flush with the midpoint of the tracheal bulge. The accurate location (optimal and acceptable position) of the RDLT and the time of intubation were recorded. The occurrence of intraoperative adverse events such as transient hypoxemia, airway resistance, carina and bronchial injuries, and postoperative sore throat were recorded.
Results Compared with the traditional group, the accurate location of the RDLT in the combination group was significantly improved, the intubation time was significantly shortened, the incidences of transient hypoxemia, airway resistance, tracheobronchial injury, and postoperative sore throat were significantly decreased (P < 0.05).
Conclusion The technology of CT measurement combined with flexible video bronchoscope is superior to the traditional method of fiberoptic bronchoscope in accurate localization, shortening intubation time, and reducing the occurrence of adverse events. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
