不同插管方法引导双腔支气管导管在预测困难气道患者胸外科手术麻醉插管中的应用效果

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Abstract Objective To compare the application effect of different intubation methods in guiding double lumen endobronchial tube (DLT) for the thoracic surgery anesthesia intubation in patients with predictable difficult airway.Methods From March 2015 to December 2018,69 patients with predictable difficult airway before anesthesia for thoracic surgery in our hospital were selected as the study subjects.They were divided into group A (23 cases),group B (23 cases) and group C (23 cases) according to the random number table method,three groups of patients were respectively given direct laryngoscope,video laryngoscope,fiberoptic bronchoscopy for DLT intubation.The intubation time,the success rate of one-time intubation,the incidence of intraoperative hypoxemia,the intraoperative DLT translocation rate,and the incidence of postoperative complications after intubation in the three groups were compared.The hemodynamic parameters (mean arterial pressure [MAP],heart rate [HR]) in three groups of patients were recorded before anesthesia (T0),immediately after induction of anesthesia (T1),immediately after intubation (T2),1 minute after intubation(T3),and 5 minutes after intubation (T4).Results The intubation time in group C was shorter than that in group A and group B,and the difference was statistically significant (P<0.05).The success rate of one-time intubation in group C was higher than that in group A,and the difference was statistically significant (P<0.05).The incidence of intraoperative hypoxemia in group C was lower than that in group A,and the difference was statistically significant (P<0.05).The intraoperative DLT translocation rate in group C was lower than that in group A and group B,and the difference was statistically significant (P<0.05).The total incidence of postoperative complications in group C was lower than that in group A,with statistically significant difference (P<0.05).There were no significant differences in MAP and HR at T0and T1among the three groups (P>0.05).The MAP of patients in group C was lower than that in group A and group B at T2,T3,and T4,with statistically significant differences (P<0.05).The HR of group C was lower than that of group A and group B at T2,and the differences were statistically significant (P<0.05).There were no significant differences in HR at T3and T4among the three groups (P>0.05).Conclusion Application of fiberoptic bronchoscopy in guiding DLT for the thoracic surgery anesthesia intubation in patients with predictable difficult airway is safe and feasible,which has short intubation time,few complications after intubation,small hemodynamic fluctuation amplitude,accurate positioning,and low incidence of intraoperative hypoxemia,which is worthy of clinical promotion and application in thoracic surgery.

Key words： Different intubation methods Double lumen endobronchial tube Difficult airway Thoracic surgery Anesthesia intubation

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	YU Pin-xian
	LIN Li-juan
	WANG Zhu

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YU Pin-xian,LIN Li-juan,WANG Zhu. Application effect of different intubation methods in guiding double lumen endobronchial tube for the thoracic surgery anesthesia intubation in patients with predictable difficult airway[J]. 中国当代医药, 2020, 27(2): 163-167转171.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2020/V27/I2/163

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