Coopdeeh支气管封堵器在困难气道患者中行单肺通气临床研究.docVIP

Coopdeeh支气管封堵器在困难气道患者中行单肺通气临床研究 　　[摘要] 目的 探讨Coopdeeh支气管封堵器在困难气道患者行单肺通气的效果与意义。 方法 选取术前经评估为气道困难的患者60例，随机分为观察组与对照组各30例。观察组使用Coopdeeh支气管封堵器进行单肺通气，对照组使用双腔气管导管进行治疗。比较两组患者不同通气方式治疗后插管成功率、插管时间、各项生命体征变化等指标。 结果 应用支气管封堵器的观察组患者插管时间及肺萎陷质量、术后咽痛声嘶人数指标均显著优于对照组（P0.05）且患者生命体征中气道压力及呼末二氧化碳分压行支气管封堵术的观察组显著低于对照组（P0.05）。 结论 对困难气道患者行Coopdeeh支气管封堵器效果确切，并发症少，尤其适合困难气道患者行单肺通?狻? 　　[关键词] Coopdeeh支气管封堵器；困难气道；单肺通气 　　[中图分类号] R562 [文献标识码] A [文章编号] 2095-0616（2017）13-198-03 　　[Abstract] Objective To explore the effect and significance of Coopdeeh bronchial occluder in one lung ventilation in patients with difficult airway. Methods 60 patients with airway difficulties performed as preoperative evaluation were selected and randomly divided into observation group and control group with 30 cases in each. Patients in observation group were treated with Coopdeeh bronchial occluder for one lung ventilation， and patients in control group were treated with double lumen endotracheal tube. The success rate of intubation， the time of intubation and the changes of vital signs after treatment with different ventilation methods of the two groups were compared. Results Intubation time and atelectasis quality， postoperative sore throat hoarseness index number of observation group were significantly better than those of control group（P0.05）. Airway pressure and end tidal CO2 pressure in vital signs of observation group were lower than those of control group（P0.05）. Conclusion For patients with difficult airway， the Coopdeeh bronchial occluder is effective. It has less complications， especially for difficult airway patients with single lung ventilation. 　　[Key words] Coopdeeh bronchial occluder； Difficult airway； One lung ventilation 　　双腔支气管插管法作为胸科手术中进行单肺通气的最常见的方式之一，由于外径较粗且有效管腔较小，存在对位困难，气道压力较高的缺陷且可供选择的型号较少，在使用过程中可能导致患者发生低氧血症[1-2]。Coopdeeh支气管封堵管是由日本研制的支气管堵塞器，具有操作简单，定位准确的优势，其低压高容套囊对呼吸道损伤较小。通过利用气囊阻塞单侧支气管不仅具有与双腔支气管导管同样满意的肺隔离与通气效果，更具有肺隔离完全及生理干扰小的优势，更有助于解决困难气道患者单肺通气的问题。本研究为探讨Coopdeeh支气管封堵器对困难气道患者单肺通气的临床影响与意义，特选取100例术前评估存