A Randomized Controlled Study Of Ultrasound And CT Multi-planar Reconstruction For The Selection Of Left Double-lumen Tube Sizes In Thoracic Surgery

Objective: In thoracic surgery anesthesia,the selection of double-lumen endotracheal tube size is usually estimated by anesthesiologists according to the height and gender of the patients.Currently,there is no objective unified standard,and the inappropriate size of endotracheal tube often causes corresponding complications.In this study,transverse diameter of cricoid cartilage(TD-C)was measured by ultrasound and CT MPR to compare the advantages and disadvantages of the two methods and to predict the accuracy of LDLT size selection.To provide a clinical basis for reducing the injury caused by the inconsistency of LDLT size in patients undergoing thoracic surgery and reducing the intraoperative and postoperative complications.Methods: The first part was divided into observational studies,and in 120 cases of single lung ventilation and patients who met the inclusion and exclusion criteria,the LDLT was selected according to the height and gender;and to record the patient’s optimum LDLT and collect the TD-C of ultrasound and CT MPR patient data,obtain the corresponding different types of LDLT ultrasound and CT MPR measurement of the TD-C range.The second part was a randomized controlled study.A total of 102 patients were divided into the ultrasound group and the CT MPR group.In the ultrasound group,TD-C was measured by ultrasound,and the corresponding type for intubation was selected and its accuracy was judged based on the conclusions derived from the first part.In the CT MPR group,TD-C was measured by CT MPR,and the corresponding type for intubation was selected and its accuracy was judged based on the conclusions derived from the first part.The success rate of intubation was recorded,and the accuracy of the LDLT was compared between the two groups.Results: In the first part,the basic characteristics were no significant difference(P > 0.05).Ultrasonic measurement TD-C range was as follows: 32 Fr <15.88 mm,35Fr: 15.88mm～16.80 mm,37Fr:16.75mm～17.81 mm,and 39 Fr >17.80 mm.CT MPR measurement TD-C range was as follows: 32 Fr <15.74 mm,35Fr: 15.74mm～16.65 mm,37Fr: 16.56mm～17.68 mm,and 39 Fr >17.65 mm.In the second part,102 patients undergoing single-lung ventilation and LDLT insertion were included,and there was no significant difference in the general condition between the two groups(P > 0.05).In addition,there was no significant difference in the distribution of the proportion of each type of LDLT between the two groups(P > 0.05).The accuracy rate of intubation in the ultrasound group was 90.2% and the corresponding rate in the CT MPR group was 94.1%,with no significant difference in intubation accuracy between the two groups(P > 0.05).Conclusion: The accuracy of selecting the LDLT based on TD-C measured by ultrasound and CT MPR is significantly higher than that based on the traditional experience;it can significantly reduce the intraoperative and postoperative complications and there is no statistical difference in the accuracy of selecting the LDLT by ultrasound and CT MPR,all can be safely used in the evaluation of anesthesia before endotracheal intubation in thoracic surgery.