国际麻醉学与复苏杂志   2015, Issue (6): 10-10
    
“J”状塑型双腔气管导管插管操作对成功率及术后声音嘶哑、咽喉痛的影响
吕晓红, 王虎山, 顾晓营, 张文文, 段宗生1()
1.吉林大学白求恩第一医院麻醉科
The comparison of the influence of "J" shape on the success rate of intubation to double-lumen endotracheal tube and postoperative hoarseness, sore throat
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摘要:

目的 观察双腔气管导管(double-lumen endotracheal tube, DLT)塑型对插管成功率及术后声音嘶哑(声嘶)、咽喉痛的影响,从而为寻求更好的DLT塑型插管提供依据。 方法 择期全身麻醉下行胸科手术患者160例,美国麻醉医师协会(ASA)分级Ⅰ~Ⅲ级,参照随机数字表法分成DLT插管塑型组和非塑型组(每组80例),两组根据左右DLT插管各分为两组(A、B、C、D组,每组40例),又根据性别再各分为两个亚组(A1、A2、B1、B2、C1、C2、D1、D2组,每组20例)。两组均采用经口明视气管插管,塑型组采用塑成“J”状的DLT进行插管,非塑型组采用未经塑型保留原有弯度的DLT进行插管。观察DLT插管时间、插管尝试次数及插反情况,患者术后声嘶、咽喉痛发生率及严重程度。 结果 塑型组插管时间[(154±6) s]明显短于非塑型组[(185±13) s](P<0.05);塑型组插管尝试次数[(1.4±0.4) 次]明显少于非塑型组[(1.7±0.8) 次](P<0.05);塑型组插反情况(3次)明显比非塑型组少(11次)(P<0.05),且与性别无关,但左DLT比右DLT易于插反(P<0.05)。患者术后声嘶发生率塑型组(15/80)明显低于非塑型组(33/80)(P<0.05);患者术后咽喉痛发生率塑型组(15/80)明显低于非塑型组(31/80)(P<0.05),且与性别有关,女性较男性术后易发生声嘶、咽喉痛。 结论 “J”状DLT塑型插管成功率高、刺激小,可降低患者术后声嘶、咽喉痛发生率,具有一定的临床推广意义。

关键词: “J”状塑型双腔气管导管; 插管成功率; 声音嘶哑; 咽喉痛
Abstract:

Objective To observe the success rate of intubation of shaping double-lumen endotracheal tube(DLT) and postoperative hoarseness, sore throat, and to seek better DLT shaping provides the basis for intubation. Methods One hundred and sixty patients of ASAⅠ-Ⅲ with elective thoracic surgery under general anesthesia, randomly divided into the shape group and the no shape group to intubate DLT(n=80). Each group according to each DLT is divided into two groups(group A, B, C, D, n=40), and according to gender and each is divided into two subgroups(group A1, A2, B1, B2, C1, C2, D1, D2, n=20). Two groups all use bright trachea intubation through the mouth, shape group adopts the "J" shape of DLT. The data related to intubation and positioning was recorded: intubation time, intubation attempts and the situation of reversing, the incidence and severity of postoperative hoarseness and sore throat were assessed. Results Two groups of patients with intubation time were(154±6) s and(185±13) s respectively(P<0.05), two groups of patients with intubation attempts were(1.4±0.4) times and(1.7±0.8) times respectively(P<0.05), and two groups of patients with the situation of reversing were 3 times and 11 times respectively(P<0.05). Comparison between the two groups for intubation time, intubation attempts and the situation of reversing, shape group were less than the no shape group, and has nothing to do with gender, but the left DLT than the right was easy to reverse. Two groups of patients with incidence of postoperative hoarseness is 15/80 and 33/80 respectively(P<0.05), two groups of patients with the incidence of postoperative sore throat were 15/80 and 31/80 respectively(P<0.05). Incidence of postoperative patients with hoarseness, sore throat, the shape group set lower than the no shape group overall(P<0.05), and was associated with gender. Conclusions “J” shape DLT intubation has the higher success rate and the smaller stimulation, can reduce the incidence of patients with postoperative hoarseness, sore throat, and has a certain clinical significance.

Key words: “J” type shaping double-lumen endotracheal tube; Success rate of intubation; Hoarseness; Sore throat