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| 加长型光棒引导硅胶双腔管在困难气道患者双腔管插管中的应用 |
| Application of elongated lightwand-guided silicone double-lumen tube in double-lumen tube intubation in patients with difficult airway |
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| DOI：10.12089/jca.2026.08.007 |
| 中文关键词: 气道管理 困难气道 加长型光棒 可视喉镜 硅胶双腔管 双腔管插管 |
| 英文关键词: Airway management Difficult airway Elongated lightwand Video laryngoscope Silicone double-lumen tube Double-lumen tube intubation |
| 基金项目:亳州市重点研发计划项目（bzzc2024016） |
| 作者 | 单位 | E-mail | | 解凤磊 | 236800,安徽省亳州市,亳州市人民医院麻醉科 | | | 朱昌娥 | 上海交通大学医学院附属儿童医院麻醉科 | | | 王峰 | 236800,安徽省亳州市,亳州市人民医院麻醉科 | 240623906@qq.com | | 赵腾飞 | 236800,安徽省亳州市,亳州市人民医院麻醉科 | | | 邱涛 | 236800,安徽省亳州市,亳州市人民医院麻醉科 | | | 黄雨婷 | 236800,安徽省亳州市,亳州市人民医院麻醉科 | | | 刘伟 | 236800,安徽省亳州市,亳州市人民医院麻醉科 | |
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| 中文摘要: |
目的： 观察加长型光棒引导硅胶双腔管在困难气道患者双腔管插管中的应用效果。
方法： 选择2025年1—10月择期胸外科单肺通气手术的困难气道患者，年龄18～64岁，BMI 18.5～30.0 kg/m2，ASA Ⅰ—Ⅲ级，术前简化气道风险指数（SARI）评分≥3分。采用随机数字表法将患者分为两组：光棒引导组（TG组）和可视喉镜辅助组（VG组）。TG组采用加长型光棒引导插管，VG组采用可视喉镜辅助插管，两组均使用硅胶双腔管。主要指标为气管插管时间。次要指标包括气道评估指标、首次置管成功率、置管阻力情况、低氧血症发生率，麻醉诱导前即刻、麻醉诱导后1 min、插管后1、5 min HR和MAP。不良反应包括术后咽喉疼痛、声音嘶哑和饮水呛咳。
结果： 共纳入患者80例，每组40例。与VG组比较，TG组气管插管时间明显缩短，首次置管成功率明显升高，置管阻力明显减小，插管后1、5 min HR明显减慢、MAP明显降低，术后咽喉疼痛发生率明显降低（P<0.05）。
结论： 加长型光棒引导硅胶双腔管在困难气道患者双腔管插管中气管插管时间更短、首次置管成功率更高、置管阻力更小、生命体征更平稳，术后咽喉部疼痛发生率更低，是一种有效安全的困难气道双腔管插管方法。 |
| 英文摘要: |
Objective: To observe the clinical efficacy of elongated lightwand-guided silicone double-lumen tube for double-lumen tube intubation in patients with difficult airway.
Methods: Patients with a difficult airway scheduled for elective thoracic surgery requiring one-lung ventilation from January 2025 to October 2025 were enrolled, aged 18-64 years, BMI 18.5-30.0 kg/m2, ASA physical status Ⅰ-Ⅲ, and preoperative simplified airway risk index (SARI) score ≥ 3. Patients were randomly divided into two groups using a random number table method: the lightwand-guided group (group TG) and the video-laryngoscope-assisted group (group VG). Group TG received intubation guided by an elongated lightwand, while group VG received intubation assisted by a video laryngoscope, both groups used a silicone double-lumen tube. The primary outcome was tracheal intubation time. Secondary outcomes included airway assessment parameters, first-attempt success rate, resistance during tube placement, incidence of hypoxemia, as well as HR and MAP recorded immediately before anesthesia induction, 1 minute after anesthesia induction, 1 minute after intubation, and 5 minutes after intubation. Adverse reactions included postoperative sore throat, hoarseness, and coughing on drinking.
Results: Eighty patients were enrolled in this study, 40 patients in each group. Compared with group VG, tracheal intubation time was significantly shortened, first-attempt success rate was significantly increased, resistance during tube placement was significantly reduced, HR and MAP 1 minute and 5 minutes after intubation were significantly decreased, and incidence of postoperative sore throat was significantly decreased in group TG (P < 0.05).
Conclusion: The use of an elongated lightwand-guided silicone double-lumen tube for double-lumen tube intubation in patients with difficult airway achieves shorter tracheal intubation time, higher first-attempt success rate, less insertion resistance, more stable hemodynamics, and lower incidence of postoperative sore throat. It is a simple, effective, and safe technique for double-lumen tube intubation in patients with difficult airway. |
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