Clinical efficacy analysis of double lumen endotracheal intubation in anesthesia for thoracoscopic pulmonary bulla surgery
双腔支气管插管在胸腔镜肺大泡手术麻醉中的临床成效分析

摘要

目的 探讨双腔支气管插管应用于胸腔镜肺大泡手术麻醉的效果。方法 选取北京优联医院行胸腔镜肺大疱切除术的64例患者（2018年9月至2021年2月），两组术中均采取全身麻醉，经随机数字表法分为对照组（单腔支气管插管）和观察组（双腔支气管插管），各32例。对比两组围术期血流动力学指标、一次插管成功率、肺功能状态及并发症情况。结果 T1、T2、T3、T4时刻两组比较，各组T2、T3、T4时刻与T1时刻比较，血流动力学指标无统计学意义（P＞0.05）。观察组和对照组一次插管成功率为93.75%（30/32）和96.88%（31/32），无统计学意义（P＞0.05）。观察组术后肺功能指标相对较好，而并发症发生率（12.50%）相对降低（P<0.05）。结论 双腔支气管插管通气，有助于改善患者术后肺功能指标，并发症发生率较低，术后康复效果较好，且与传统单腔管双肺通气相比，术中血流动力学指标波动、一次插管成功率未见明显升高，但双腔支气管插管通气术中通气更为灵活，有助于改善患者预后。

Abstract

Objective Exploring the effectiveness of double lumen endotracheal intubation in anesthesia for thoracoscopic pulmonary bulla surgery.
Methods Sixty-four patients undergoing thoracoscopic pulmonary bulla resection at Beijing Youlian Hospital (September 2018 to February 2021) were selected. Both groups received general anesthesia during surgery and were randomly divided into a control group (single-lumen bronchial intubation) and an observation group (double-lumen bronchial intubation), with 32 cases each. The perioperative hemodynamic parameters, single-intubation success rate, pulmonary function status, and complication rates were compared between the two groups.
Results At the T1, T2, T3, and T4 time points, there were no statistically significant differences in hemodynamic indicators between the two groups when comparing each group's T2, T3, and T4 time points with T1 (P > 0.05). The one-time intubation success rates were 93.75% (30/32) in the observation group and 96.88% (31/32) in the control group, with no statistically significant difference (P > 0.05). The observation group exhibited relatively better postoperative pulmonary function indicators and a lower complication rate (12.50%) (P < 0.05).
Conclusion   Double-lumen bronchial intubation ventilation helps improve postoperative pulmonary function indices in patients, with a lower incidence of complications and better postoperative recovery. Compared to traditional single-lumen tube bilateral lung ventilation, it does not significantly increase hemodynamic fluctuations or first-attempt intubation success rates during surgery. However, double-lumen bronchial intubation ventilation offers greater flexibility during the procedure and contributes to improved patient outcomes.