Disposcope 内镜用于双腔支气管导管插管的临床效果

目的：观察 Disposcope 内镜用于双腔支气管导管插管的临床效果。方法选择择期全身麻醉下行两切口食管癌根治术患者60例，性别不限，年龄46～67岁，ASAⅠ—Ⅱ级，术前评估无困难气道因素，应用左侧双腔支气管导管插管。将60例患者随机分为 Disposcope 内镜组（D 组）30例和 Macintosh 直接喉镜组（M 组）30例。分别于麻醉前（基础值，T0）、麻醉诱导后气管插管前（T1）、气管插管成功即刻（T2）、气管插管后1 min（T3）及3 min（T4）时记录 MAP、HR，计算 HR 与 SBP 乘积（RPP）；记录气管插管时间、首次气管插管成功率及总成功率；记录患者24 h插管并发症（口腔黏膜出血、咽喉疼痛及声音嘶哑）情况。结果D 组各时点 MAP、HR 及 RPP 比较差异均无统计学意义（P ＞0．05）。与 M 组比较，D 组 T2—T4时点 MAP、HR 及 RPP 均显著降低（P ＜0．05），插管时间显著缩短（P ＜0．05），首次插管成功率显著升高（P ＜0．05），咽喉疼痛发生率显著降低（P ＜0．05）。结论Disposcope 内镜引导双腔支气管导管插管下气管插管时间缩短，首次插管成功率升高，患者的应激反应减小。

Clinical Efficacy of Disposcope Endoscope in Bronchial Double-Lumen Tube Intubation

Objective To investigate the clinical efficacy of Disposcope endoscope in bronchial double-lumen tube（DLT）intubation.Methods Sixty ASA Ⅰ-Ⅱ patients aged 46-67 years under-went elective radical surgery for esophageal carcinoma through two incisions under general anes-thesia.Patients showed no preoperative difficult airway factors and received left DLT intubation. These patients were randomly divided into two groups：Disposcope endoscope group（group D） and Macintosh direct laryngoscope group（group M）,with 30 patients in each group.The mean ar-tery pressure（MAP）and heart rate（HR）were recorded and the rate-pressure product（RPP）was calculated by multiplying HR by systolic blood pressure（SBP）before anaesthesia induction（base-line,T0 ）,before intubation（T1 ）,immediately after successful intubation（T2 ）,1 after intubation （T3 ）and 3 minutes after intubation（T4 ）.In addition,the success rate of DLT intubation at the first attempt,total success rate of DLT intubation,intubation time,and complications（oral mucosa bleeding,sore throat and voice hoarse）within 24 hours after surgery were recorded.Results There were no significant differences in MAP,HR and RPP among different time points in group D（P 〉 0.05）.Compared with group M,the application of Disposcope endoscope decreased the MAP,HR and RPP at T2-T4 ,shortened the intubation time,increased the success rate of DLT in-tubation at first attempt,and reduced the incidence of sore throat（P 〈0.05）.Conclusion Dis-poseope endoscope-guided DLT intubation can shorten the intubation time,increase the success rate of DLT intubation at first attempt,and reduce the stress responses.