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|本期目录/Table of Contents|

两种气管导管行单肺通气在小切口冠状动脉旁路移植术中的比较(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2017年第3期
页码:
350-352
栏目:
临床研究
出版日期:
2017-01-25

文章信息/Info

Title:
Comparison of different endotracheal tubes for one-lung ventilation in patients undergoing minimally invasive direct coronary artery bypass
作者:
张铁峰; 柴金花; 李 颖; 蒋海斌
兰州市第一人民医院麻醉科，甘肃 兰州 730050
Author(s):
ZHANG Tie-feng;  CHAI Jin-hua;  LI Ying;  JIANG Hai-bin
Department of Anesthesiology, First People’s Hospital, Lanzhou 730050, Gansu, China
关键词:
插管法; 气管内; 单肺通气; 冠状动脉旁路移植术
Keywords:
intubation;  intratracheal;  one-lung ventilation;  coronary artery bypass
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 比较单腔导管与双腔支气管导管用于小切口冠状动脉旁路移植术患者单肺通气的效果。方法 择期行左胸部小切口冠状动脉旁路血管移植术患者60例，年龄65~75岁， ASA分级Ⅱ~Ⅲ级，Mallampati分级Ⅰ~Ⅱ级，心功能(NYHA)Ⅱ~Ⅲ级,随机分为2组，单腔导管组和双腔支气管组，每组30例。麻醉诱导后单腔导管组采用单腔气管导管，一次性插入右侧总支气管。双腔导管组选择Robershaw 右双腔支气管导管。分别于麻醉诱导前、插管定位成功后、手术结束后记录患者SBP、DBP和HR。并且于诱导前（T0）、插管定位成功后（T1）、开胸后30 min（T2）、术毕拔出气管导管30 min（T3）时从桡动脉抽血0.5 ml进行血气分析： PO2、PCO2并记录peak值。结果 与单腔导管组比较双腔导管组在插管后SBP、DBP、HR明显升高(P<0.05)，PO2、PCO2无明显变化，peak值在T1、T2与双腔导管组比较明显升高(P<0.05)但均在正常范围内。结论 普通单腔气管导管于小切口冠状动脉旁路移植术老年患者单肺通气时优于双腔气管导管。
Abstract:
AIM To compare common endotracheal tube and double-lumen tube for one-lung ventilation undergoing minimally invasive direct coronary artery bypass (MIDCAB). METHODS Sixty patients aged 65-75 years (ASA II or III, Mallampati I-II, cardiac functions II or III) were randomly divided into two groups: common endotracheal tube group and double lumen endotracheal tube group, with 30 patients in each group. After anesthesia induction, patients in common endotracheal tube group were intubated with a single-lumen tube into the total bronchus of the right side and patients in double-lumen tube group were intubated with double-lumen tube of the right side. Before anesthesia induction, after intubation and postoperatively, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were calculated. Before induction (T0), 30 min after intubation (T1), 30 min after thoracotomy (T2) and 30 min after extubation (T3), blood gas analysis was conducted and PO2, PCO2 and peak values were recorded. RESULTS Compared with those of the common endotracheal tube, SBP, DBP and HR of subjects with double-lumen endotracheal tube after intubation significantly increased. No significant difference in PO2 and PCO2 was found. Peak values of T1 and T2 in common endotracheal tube group increased significantly compared with those in double-lumen tube group (P<0.05) but were within the normal range. CONCLUSION Common endotracheal tube is superior to double-lumen tube for one-lung ventilation in elderly patients undergoing minimally invasive direct coronary artery bypass.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2016-06-28.通讯作者：蒋海斌，副主任医师,主要从事心血管麻醉研究 Email：lzjianghaibin@hotmail.com 作者简介：张铁峰，主治医师，硕士 Email：66801996@qq.com
更新日期/Last Update: 2017-02-20