The Application Value Of Ultrasound Combined With Individual Parameters In Guiding The Selection Of Left Double-lumen Bronchial Tube

Objective: To study the advantages of ultrasonic measurement of tracheal diameter combined with individual parameters and routine use of sex and height in guiding the selection of suitable left double lumen bronchus in thoracic surgery.Methods: This study was divided into two steps.In the first step,100 patients(52 males and 48 females)who underwent thoracoscopic right partial pneumonectomy or wedge-shaped pneumonectomy in our hospital from June 2020 to October 2020 were selected.the internal diameter of the trachea at the sternoclavicular junction was measured before anesthesia.The type of double-lumen tube was selected according to sex and height,and the catheter adaptability was judged by cannula manometry(too large,suitable or too small).And determine a corresponding value to select the appropriate catheter based on ultrasonic measurement of endotracheal diameter,sex and height.In the second step,a total of 100 patients(including 21 males and19females)were selected and randomly divided into two groups with20 cases in each group.L-DLT was selected for group A according to the corresponding value obtained in the first step,while L-DLT was selected for group B according to gender and height.The selection rate of suitable tube,sore throat,hoarseness and cough 6 hours after extubation were compared between the two groups.Results: In the first step,the corresponding values were obtained:female: ultrasonic tracheal diameter < 17 mm selected 32 Fr R,ultrasonic endotracheal diameter 17mm-20 mm and height < 150 cm selected 32 Fr F,ultrasonic endotracheal diameter 17mm-20 mm and height > 150 cm selected 35 Fr,ultrasonic endotracheal diameter > 20 mm selected 37 Fr.men: ultrasonic endotracheal diameter < 20 mm chose 35 Fr A,ultrasonic endotracheal diameter 20mm-23 mm and height < 165 cm selected37Fr A,ultrasonic endotracheal diameter 20mm-23 mm and height >165chose 39 Fr.ultrasound endotracheal diameter > 23 mm chose 41 Fr.In the second step,there was no significant difference in preoperative general data(age,weight,height)between the two groups(P > 0.05).There was no significant difference in hoarseness,sore throat and cough 6 hours after insertion between the two groups(P > 0.05).The selection rate of suitable catheter in group A was significantly higher than that in group B,and the difference was statistically significant(p >0.05).Conclusion: Ultrasonic measurement of tracheal diameter combined with sex and height has no effect on hoarseness,sore throat and cough 6 hours after operation.Ultrasonic measurement of tracheal diameter combined with sex and height to guide the selection of left double-lumen bronchus type can significantly improve the selection rate of suitable catheter compared with sex and height alone,and can provide a reference basis for clinical selection of suitable catheter.