【原】左侧双腔支气管导管与气管和支气管尺寸的相容性：一项回顾性比较研究

左侧双腔支气管导管与气管和支气管尺寸的相容性：一项回顾性比较研究

贵州医科大学    麻醉与心脏电生理课题组

翻译：陈锐  编辑：张中伟  审校：曹莹

01

背景

双腔支气管导管 (DLT) 仍然是麻醉期间获得肺隔离的最广泛使用的方法。我们比较了DLT大小选择的建议与从大量患者群体中收集的经放射学评估的下气道尺寸。

02

方法

 在这项回顾性比较研究中，我们评估了150名没有已知气道病变的成年人的计算机断层扫描 (CT) 扫描。使用这些扫描，我们测量了气管的直径和长度以及主支气管的直径。然后将这些气道尺寸与三个不同制造商的左侧DLT的尺寸进行比较。尺寸选择基于米勒麻醉学的建议。

03

结果

我们发现推荐的 DLT 尺寸偶尔会太小，但通常会太大，尤其是在支气管内气道中。使用 DLT Vivasight-DL ®时，28.7% (43/150) 的患者发生在远端主支气管和 8% (12/150) 的气管水平。这种不匹配最常见于女性（左远端主支气管34/68，50%；气管 9/68，13.2%）。相反，对于男性患者来说，左主支气管(SHER-I-BRONCH ® : 8/82, 9.8%) 和气管 (SHER-I-BRONCH ® : 2/82, 2.4% )的DLT往往太小）。女性的支气管内管部分通常太长（Vivasight ®DLT：11/68,16%) 高于男性 (9/82,11%)。

04

结论：来自所有三个制造商的推荐 DLT 尺寸中有相当一部分与个体患者的下气道尺寸不相容。

原始文献来源:

Jan ELLENSOHN, Thomas HILLERMANN, Andreas STEINAUER et.al.Compatibility of left-sided double-lumen endobronchial tubes with tracheal and bronchial dimensions: a retrospective comparative study.[J].Minerva Anestesiologica 2021 Sep 16 DOI:10.23736/S0375-9393.21.15760-8

英文原文：

Compatibility of left-sided double-lumen endobronchial tubes with tracheal and bronchial dimensions: a retrospective comparative study

Abstract

Background: Double-lumen endobronchial tubes (DLT) continue to be the most widely used method for obtaining lung isolation during anesthesia. We compared recommendations for DLT size selection with radiologically assessed lower airway dimensions gathered from a large patient population.

Methods: For this retrospective comparative study, we assessed computed tomography (CT) scans of 150 adults with no known airway pathologies. Using these scans, we measured the diameter and length of the trachea and the diameter of the mainstem bronchi. These airway dimensions were then compared to the dimensions of left-sided DLTs of three different manufacturers. Size selection was based on one standard textbook's recommendations.

Results: We found the recommended DLT sizes were occasionally too small but more often too large, particularly in the endobronchial airway. With the DLT Vivasight-DL®, mismatching occurred in 28.7% (43/150) of the patients at the distal mainstem bronchus and 8% (12/150) at the tracheal level. This mismatching happened most often in females (left distal mainstem bronchus 34/68, 50%; trachea 9/68, 13.2%). Conversely, the DLT was more often too small for male patients in both the left main bronchus (SHER-I-BRONCH®: 8/82, 9.8%) and the trachea (SHER-I-BRONCH®: 2/82, 2.4%). The endobronchial tube portion was more often too long in females (Vivasight® DLT: 11/68, 16%) than males (9/82, 11%).

Conclusions: A considerable proportion of the recommended DLT sizes from all three manufacturers was incompatible with individual patient's lower airway dimensions.