摘要
目的 探讨全身麻醉(以下简称“全麻”)联合可视双腔气管导管在肺尘埃沉着病患者大容量灌洗术肺隔离中的应用效果。方法 选取2022年1月至2023年12月赣州市第五人民医院呼吸科的80例肺尘埃沉着病患者作为研究对象,按照随机数字表法分为对照组和观察组,每组40例。对照组采用全麻联合普通双腔气管导管,观察组采用全麻联合可视双腔气管导管。比较两组患者的一次插管成功率、插管时间、术后不同时间点的舒适度[视觉模拟评分法(VAS)评分]、不良反应发生率、导管移位相关不良事件发生率、患者满意度、大容量全肺灌洗术费用及住院费用、围手术期的应激激素[皮质醇(Cor)、β-内啡肽(β-EP)及醛固酮(ALD)]及血流动力学(收缩压及心率)。结果 观察组的一次插管成功率高于对照组,插管时间短于对照组,术后6、12、24 h的VAS评分低于对照组,不良反应总发生率及导管移位相关不良事件总发生率低于对照组,患者总满意率高于对照组,差异有统计学意义(P<0.05)。两组患者的大容量全肺灌洗术费用及住院费用比较,差异无统计学意义(P>0.05)。两组患者术前的应激激素及血流动力学比较,差异无统计学意义(P>0.05);观察组插管即刻及术中3 min的应激激素及血流动力学均低于对照组,差异有统计学意义(P<0.05)。结论 全麻联合可视双腔气管导管在肺尘埃沉着病患者大容量灌洗术肺隔离中的应用效果相对更好,更有助于控制机体不适感、不良应激,提高插管成功率,安全性也相对更高。
Objective To investigate the application effect of general anesthesia combined with visual double-lumen endotracheal tube in lung isolation of patients with large volume lavage surgery for pneumoconiosis.Methods A total of 80 patients with pneumoconiosis in the Department of Respiratory of the Fifth People's Hospital of Ganzhou City from January 2022 to December 2023 were selected as research objects,and they were divided into control group and observation group according to random number table method,with 40 cases in each group.The control group received general anesthesia combined with common double-cavity tracheal catheter,and the observation group received general anesthesia combined with visual double-lumen endotracheal tube.The success rate of one-time intubation,intubation time,postoperative comfort at different time points(visual analogue scale[VAS]score),incidence of adverse reactions,incidence of adverse events related to catheter displacement,patients'satisfaction,cost of large volume lavage surgery and hospitalization,perioperative stress hormone(cortisol[Cor],β-endorphin[β-E],aldosterone[ALD])and hemodynamics(systolic blood pressure and heart rate)were compared between two groups.Results The success rate of one intubation in the observation group was higher than that in the control group,the intubation time was shorter than that in the control group,the VAS scores at 6,12 and 24 h after surgery were lower than those in the control group,the total incidence of adverse reactions and total incidence of adverse events related to catheter displacement were lower than those in the control group,and the total satisfaction rate of patients was higher than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in the cost of large volume lung lavage and hospitalization between the two groups(P>0.05).There were no significant differences in preoperative stress hormone and hemodynamics between the two groups (P>0.05). The stress hormones and hemodynamics of the observation group immediately after intubation and 3 min after operation were lower than those of the control group, and the differences were statistically significant (P<0.05). Conclusion The application of general anesthesia combined with visual double-lumen endotracheal tube in lung isolation of patients with large volume lavage surgery for pneumoconiosis is relatively better, more helpful to control body discomfort and adverse stress, improve the success rate of intubation, and relatively higher safety.
作者
钟庆华
邓育骋
刘绮
陈林
ZHONG Qinghua;DENG Yucheng;LIU QiCHEN Lin(Department of Anesthesiology,the Fifth People's Hospital of Ganzhou City,Jiangxi Province,Ganzhou341000,China)
出处
《中国当代医药》
2024年第36期104-108,共5页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202312087)
江西省赣州市科技计划项目(GZ2023ZSF280)。
关键词
全身麻醉
可视双腔气管导管
肺尘埃沉着病
大容量灌洗术
肺隔离
General anesthesia
Visual double-lumen endotracheal tube
Pneumoconiosis
Large volume lavage surgery
Lung isolation
