| Objective: When inserting and positioning the double-lumen tube,by comparing the success rate and one-time success rate of HC-videolaryngoscope with fiberoptic bronchoscopy(henceforth FOB)and Macintosh direct laryngoscope(henceforth MDLS),calculating the whole time of inserting and positing the tube,and analyzing the influence of the injury situation of the oropharyngeal to the hemodunamic,the thesis aims the evaluate the practical prospect and clinical value of the HC in the insertion and position and double-lumen tube.Methodology1.Research objects.The research chooses 40 in-patients of the thoracic surgery in the Hospital of xxx,from September 2014 to November,2015.All of the in-patients who are of ASA I-II and are of18-65 years old,need the selective operation to insert the double-lumen tube under general anesthesia.None of the patients suffer from the expected difficult airway,serious cardiovascular disease before the operation,hepatic and kidney function deficiency,metabolic abnormalities and leaving the nasogastric tube before the operation.All of the patients are divided into two groups,namely,HC group and MDLS group,with 20 patients respectively.2.Experimental methodsAll of the patients are prohibiting from smoking and drinking water.After the preparation of the anesthesia,the patients are intravenous injected of mid0.05mg/kg、sufentanil0.4ug/kg 、 cisatracurium0.2mg/kg 、 etomidate0.2mg/kg to lead them into anesthesia,and at the same time are put on the oxygen mask to get rid of the nitrogen,finally they are injected cisatacurium for 3 minutes to insert the double-lumen tube.The research chooses HC in Group A and MDSL in Group B.Data collectionThe times are arranged as follows:To: Before the anesthesia T1: Before inserting the tube,and after the anthesthesia T2: When epiglottis exposed,and HC reaches the glottis T3: After the endotracheal tube are put in the trachea T4: 1 minute after the injection of the tube T5: 3 minutes after the injection of the tubeThe research should record the C-L classification,the time after inserting the tube,the number of intubation,hemodynamics data of the points of the time in every inserting and positing of the tube,and the return visit after the operation in 24 hours.Results:1.The comparison of the success rate of inserting and positioning shows that the level of Group A and Group B are basically flat;and the success rate of one-time inserting of Group A is obviously higher than that of Group B.The results are statistically significant.2.The time of inserting in Group A is shorter than than that in Group B,.The results are statistically significant.3.The injury condition in Group A(10%)is obviously lower than that in Group B(25%).The results are statistically significant.4.In T2 and T3,the parameter of SBP/DBP/MAP/ and HR in Group A of the variation in blood pressure and heart rate is obviously lower than that in Group B.The results are statistically significant.The wave of the hemodynamic in Group A is obviously lower than that in Group B.The results are statistically significant.Conclusion1.During the inserting and positioning of the double-… tube,the comparative results of shows that in the experimental group,the time of inserting the tube is shorter,one-time success rate is higher,the level of changement in hemodynamic is lower and the postoperative complication is slighter.2.The use of HC in inserting the double-lumen tube can help to improve the one-time success rate,to decrease the postoperative complication,to lighten the stress reaction of the patients to the tube.It is a new method to insert the double-lumen tube to the tube and appears to be affective. |
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