| 卜先龙,万宗明,方存贵,等.右美托咪定联合可视双腔支气管导管技术在胸腔镜手术的临床应用[J].中国临床保健杂志,2019,22(3):403-405. |
| 右美托咪定联合可视双腔支气管导管技术在胸腔镜手术的临床应用 |
| Clinical observation of dexmedetomidine combined with visual double-chamber bronchial catheter in thoracoscopic surgery |
| 投稿时间：2018-11-19 |
| DOI：10.3969/J.issn.1672-6790.2019.03.030 |
| 中文关键词: 胸腔镜检查 围手术期 导管插入术 肾上腺素能α激动剂 |
| 英文关键词: Thoracoscopy Perioperative period Catheterization Adrenergic alpha-Agonists 〖FL |
| 基金项目:安徽省教育厅重点项目(KJ2015A149) |
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| 中文摘要: |
| 目的 观察右美托咪定(DEX)联合可视双腔支气管导管(DLT)技术对胸腔镜手术中的应用价值。 方法 将60例选择性经胸腔镜肺手术患者根据数字表法随机分为对照组(普通左侧 Robertshaw-DLT)和研究组(右美托咪定联合可视左侧Robertshaw-DLT),各30例。对照组静脉麻醉诱导后插入DLT采取听诊法定位,研究组经静脉输注DEX 0.8 μg/kg 10min,在诱导静脉麻醉后,通过导管壁的内置摄像头置入DLT以完成定位。随后以0.5 μg·kg-1·h-1的速率输注DEX至手术结束前30 min。记录插管、拔管期的不良反应发生率；观察气管和隆突黏膜损伤情况及术后咽痛、声音嘶哑及咳嗽等发生率。 结果 与对照组相比,研究组插管、拔管期平均动脉压、心率较平稳(P<0.05),呛咳、躁动发生率低；研究组手术结束后发现2例气管及隆突黏膜轻度损伤,而对照组有9例轻、中度损伤；研究组术后咽痛、咳嗽等并发症的发生率亦明显下降。 结论 右美托咪定联合可视双腔支气管导管技术用于经胸腔镜肺手术,围手术期患者循环更加稳定、不良反应发生率小,术后气道并发症发生率明显降低。 |
| 英文摘要: |
| Objective To observe the value of dexmedetomidine (DEX) combined with visual double-chamber bronchial catheter (DLT) in the thoracoscopic surgery. Methods 60 patients who underwent elective thoracoscopic lung surgery were selected and randomly divided into the control group (normal Robert shaw-dlt on the left) and the experimental group (dexmedetomidine combined with visible Robert shaw-dlt on the left) with 30 patients in each group according to the numerical table method.In the control group,after intravenous anesthesia induction,DLT was inserted and auscultation was performed.The experimental group was treated with intravenous infusion of DEX 0.8 μg/kg 10min.and after intravenous anesthesia induction,DLT was inserted to complete positioning through a built-in camera on the catheter wall.Then the infusion was performed at a rate of 0.5 μg·kg-1·h-1 until 30 min before the end of the surgery.The incidence of adverse reactions during intubation and extubation was recorded,and the injury of trachea and carina mucosa and the incidence of pharyngeal pain,hoarseness and cough were observed. Results Compared with the control group,the average arterial pressure and heart rate during intubation and extubation in the experimental group were stable (P<0.05),and the incidence of choking and restlessness was low.After the operation,2 cases of trachea and carina mucosa injury were found in the experimental group,while 9 cases of mild and moderate injury were found in the control group.The incidence of postoperative complications such as pharyngeal pain and cough also decreased significantly (P<0.05) in the experimental group. Conclusion Perioperative patients have more stable circulation and lower incidence of adverse reactions and the incidence of postoperative airway complications by using dexmedetomidine combined with visual double-chamber bronchial catheter technique during thoracoscopic pulmonary surgery. |
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