Comparison Of Bronchial Blocker And Double Lumen Endotracheal Tube Used In The Radical Resection Of Esophagus Cancer

Objective:Compare the clinical application effects between bronchial blocker and double lumen endotracheal tube in patients with radical resection of esophagus cancer.Methods:Selecting 60 cases of patients with esophageal cancer were going to treat with esophageal cancer radical surgery in our hospital,They were randomly divided into 2groups,according to the mode of one lung ventilation: group of bronchial blockers(BBs)and group of double lumen endotracheal tube(DLT).All cases with anesthesia induction,cases of BBs group were first inserted the single lumen endotracheal tube through mouth,then insert the bronchial blocker to the corresponding side of endobronchial guided by fiber bronchoscope.Cases of DLT group were inserted the double lumen endotracheal tube through mouth,and then both groups were adjusted by fiber bronchoscope.Intraoperative strictly monitor and recorded the following indicators:(1)Recorded the patients’ general conditions(gender,age,height,weight,and ASA score),side,duration of one lung ventilation;(2)Record the time to lung collapse,airway resistance when one lung ventilation and collapsed lung score;(3)Radial artery blood was obtained after one lung ventilation for blood gas analysis,and recorded the following indicators: the results of PH,PaO2,PaCO2,HCO3-and BE;(4)ELISA methods were applied to detect the levels of TNF-α,IL-6 and IL-8 in ventilation alveolar lavage fluid;(5)Follow-up the occurrence of hoarseness,sore throat,within 24 h and pulmonary complications happen in 72 h after tracheal extubation.Results:1.No statistical differences was observed about the patients’ general conditions,side,and duration of one lung ventilation between the two groups(all P>0.05).2.The airway resistance in BBs group was significant lower than DLT group(P<0.05),but the time to lung collapse of BBs group was significant longer than DLTgroup(P<0.05).No statistical difference was observed about the collapsed lung score between the two groups(P>0.05).3.No statistical difference was observed about the blood gas analysis(PH,PaO2,PaCO2,HCO3-,BE)between the two groups(all P>0.05).4.There was a significant down-regulation in BBs group about the levels of TNF-α,IL-6 and IL-8 in ventilation alveolar lavage fluid,and with a statistical difference(all P<0.05).5.The the occurrence of sore throat in BBs group was significant lower than DLT group(P<0.05),While no statistical difference was observed about the occurrence of hoarseness and pulmonary complications between the two groups(both P>0.05).Conclusions:1.Compared with the double lumen endotracheal tube,bronchial blocker have many advantages,such as lower airway resistance,less affect of lung inflammatory factors,lower occurrence of sore throat.While the time to lung collapse of bronchial blocker was longer than double lumen endotracheal tube in rhe radical resection of esophagus cancer.2.There was no significant difference about the affect of blood gas analysis,the collapsed lung score,the occurrence of hoarseness and pulmonary complications between the two ways of one lung ventilation.