Univent单腔双囊气管导管在小儿单肺通气中的应用

摘要

目的：将Univent单腔双囊气管导管用于8～14岁小儿胸部外科手术以期实现小儿单肺通气。方法：择期行肺叶切除术患儿12例，在芬太尼、异丙酚、潘库溴铵静脉麻醉诱导下插入单腔双囊支气管堵塞导管，用听诊法判断目标侧肺是否完全堵塞。术中机械通气，常规进行循环、呼吸监测。结果：右侧开胸7例，6例放置满意，1例术中见右肺膨胀，放弃使用。左侧开胸5例，1例反复放置不能达目标侧，放弃使用。结论：Univent单腔双囊气管导管用于小儿肺叶切除术，患侧肺萎陷，手术暴露操作满意，患儿呼吸、循环稳定，是实现小儿单肺通气的方法之一。%Objective:To evaluate the use of Univent-endotracheal tube with movable blocker in children one-lung ventilation.Methods: Twelve patients who received selective lobectomy underwent Univent-endotracheal tube and movable blocker under anesthesia of fentanyl and propofol. Auscultation was used to monitor if the lung was completely blocked. The changes ofHR,EKG,SpO2, RR, Vt, MV, and PetCO2 were observed during the surgery. Results:In right thoracotomy, endotrachealtube was in proper position in 6 of 7 patients, and one patient happened pulmonary hypertroply and was operated by doublelung ventilation. In left thoracotomy,it was in proper position in 4 of 5 patients,and one patient failed during intubation.Conclusion:Univent tubes can be used in one-lung ventilation in lobectomy for the purpose of facilitating surgical exposureand stabilizing respiration and circulation. It is one of the one-lung ventilations in pediatrics.