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Updated: Sep 11, 2025

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90°与110°的左双流管旋转用于内支气管输管:一个随机对照试验
Huiying Zhou1, Jiale Zhao1, Xiang Quan1
1Department of Anaesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Journal of thoracic disease
|August 14, 2025
概括
旋转左双光管 (DLT) 110°逆时针方向,改善了胸部手术期间左支气管输管的第一次成功尝试. 此外,与传统的90度旋转相比,这种技术还可以减少术后喉疼痛.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 航空航道管理的管理.
背景情况:
- 常规的90°逆时针旋转左双流管 (DLT) 进行内支气管输入有75.9%的第一次尝试成功率.
- 左侧主要支气管倾斜角度 (108.4°) 表明一个潜在的更有效的旋转角度.
研究的目的:
- 为了比较使用110°与90°逆时针方向的DLT旋转的左内支管管道输入的第一次尝试成功率.
- 为了评估与每一个旋转角度相关的气道损伤和输管相关的并发症.
主要方法:
- 一项随机对照研究,涉及556名接受胸部手术的成年患者,左侧DLT输管.
- 首次尝试成功率的比较,光纤支气管镜检查30分钟后的呼吸道损伤结果,以及24小时后的术后喉痛和声.
主要成果:
- 110度旋转组的第一次尝试成功率 (87.9%) 与90度旋转组 (80.7%;P=0.02) 相比显著更高.
- 110度组报告了手术后喉疼痛的发病率较低 (33.9%与45.8%相比;P=0.005).
- 在卡里纳粘膜损伤或手术后声方面,两组之间没有发现显著差异.
结论:
- 左右DLT的反时针旋转110°提高了在接受胸部手术的成年患者中首次尝试左支支气管输管的成功率.
- 这种优化的旋转技术似乎也减少了手术后喉疼痛的发生率.
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