- 期刊
麻醉病人翻身後雙導管支氣管內管移位的發生率
The Incidence of Double-Lumen Tubes Displacement after Positioning of Patients during Anesthesia
摘要
背景：許多報告指出，使用雙導管支氣管內管(double-lumen endobronchial tube, DLT)的病人在翻身後會發生DLT的移位，但目前國內尚無有關的研究報告。本研究在探討使用DLT的病人在翻身從DLT移位的發生率，並討論其解決方法。方法：本研究選擇80位接受胸腔手術需使用左側DLT作左側支氣管插管的病人，利用光纖維氣管內視鏡測量DLT氣管內管前端開口與氣管分叉處的距離在翻身前後之變化。結果：八十名病人中DLT向近端移動1.5公分者有18人(22.5%)，移動1公分者有16人(20%)，移動0.5公分者有8人(10%)，其餘38人(47.5%)沒有移動，因DLT移動導致無法正常有效分隔兩肺而需重新調整位置者有9人(11.25%)。結論：從我們的結果顯示，病人翻身後DLT移位的發生率相當高，大家均應重視此一現象，針對發生的可能原因，儘量減少其發生的機率，提高使用DLT時的安全性。
並列摘要
Background: Although many reports have described that unexpected displacement of double-lumen endobronchial tube (DLT) may be caused by patient positioning, however, in Taiwan the matter has not been reported, nor its incidence has been determined. The purpose of this study was to determine the incidence of DLT displacement after patient positioning. Methods: Eighty patients undergoing elective thoracotomy that required an anesthesia with the use of left DLT were studied. An Olympus LF-P broncho-fiberscope was used to estimate the distance between the carina and the distal end of the DLT via the tracheal lumen before and after patient positioning. Results: All DLT were confirmed to be in the correct position in eighty patients before patient positioning. After patient positioning, the DLT moved proximally 1.5 cm, 1 cm and 0.5 cm in eighteen (22.5%), sixteen (20%) and eight (10%) patients respectively. In nine patients (11.25%) DLT displacement after positioning resulted in a failure to ventilate the lungs separately and required readjustment of the DLT. Conclusions: Our result suggests that there is a high incidence of DLT displacement during patient positioning. Whenever the patient is repositioned, we recommend that constant vigilance is necessary to guard against tube displacement. Attention should be focused on possible causative factors so that the incidence can be decreased and the safety of DLT application assured.
延伸閱讀
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