左双腔气管导管误插入右侧主支气管后位置调整的临床经验.docVIP

左双腔气管导管误插入右侧主支气管后位置调整的临床经验 山东省潍坊市第二人民医院 摘要：目的：研究观察双腔气管导管误插入右侧主支气管后位置调整的临床病例，并进行总结。方法：我们选择了2013年1-12月间的42例首次插管误插入右侧主支气管的病例位置调整情况进行了记录和研究，记录和观察项目包括：a 导管误插右侧，退到主气管后一次调整成功。b 经过2次和3次调整成功。c 经过3次以上调整后成功。d 经过3次以上调整后仍失败，此时左右反向使用气管导管，仍能形成有效的单肺通气效果。e 调整失败，单肺通气失败。结果：42例首次插管误插入右侧的病例中a 一次调整成功者8例，占总例数的19%。b 2-3次调整成功者22例，占总数的52%。c 3次以上调整到位者2例，占总数的5%。d 3次以上调整失败后反向使用气管导管并形成有效的单肺通气者9例，占总数的21%。e 调整失败，单肺通气失败者1例，占总数的2%。结论：发生左双腔导管误插入右侧主支气管后，进行3次以内调整，成功的机会是非常大的。若3次仍失败，则不宜进行过多的尝试，此时，反向使用气管导管进行单肺通气仍不失为一个有效的办法 【Summary 】：Purpose：Study an observation double chamber windpipe pipe mistake to insert after the right side lords bronchus the position adjusts of clinical case，and carry on summary.Method：We chose 2013 for 1-12 months，42 cases positions that the mistake for putting a tube for the very first time inserts right side lord bronchus of adjusted a circumstance to carry on record and research，record and observation item to include：A pipe mistake puts a right side and back an adjustment of lord windpipe success.The b passes by 2 times with 3 adjustments successful.The c succeeds after 3 above adjustments.The d after passing by 3 times above adjust still fails，or so anti- at this time to use windpipe pipe，can still form effective single lung to ventilate effect.The e adjusts failure，the list lung ventilates failure.Result：42 mistakes that put a tube for the very first time insert a right-hand case an an adjustment successful man is 8，take up 19% of the total number of examples.B 2-3 adjustment successful mans are 22，take up 52% of the total amount.The c 3 times above adjusts a good enough 2，take up 5% of the total amount.D 3 above adjustments fail anti- behind to the use windpipe pipe also form effective single lung to ventilate 9，take up 21% of the total amount.The e adjusts failure，the list lung ventilates failed 1 and takes up 2% of the total amount.Conclusion：Carry on 3 times in the adjustment after left double of chambers pipe mistake happening to insert a right side lord a bronchus，the su