Bước đầu đánh giá hiệu quả đặt nội khí quản có bóng chẹn phế quản cho thông khí một phổi ở bệnh nhân người lớn mổ ung thư thực quản tại Bệnh viện Việt Đức=Initial effective evaluation of endotracheal tube with bronchal blocker ballfor single-lung ventilation in adult esophageal cancer surgery at Viet Duc Hospital

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Kim Dung Đào, Thị Hương Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y học cộng đồng, 2023

Mô tả vật lý: tr.212-219

Bộ sưu tập: Metadata

ID: 477585

Thêm vào giỏ

Bước đầu đánh giá hiệu quả đặt nội khí quản có bóng chẹn phế quản cho thông khí một phổi ở 10 bệnh nhân người lớn mổ ung thư thực quản. Phương pháp: Nghiên cứu cắt ngang mô tả. 10 bệnh nhân người lớn có chỉ định gây mê - phẫu thuật ung thư tạo hình thực quản ở Bệnh viện Việt Đức, thời gian từ tháng 1/2021 đến tháng 4/2022. Tiêu chí đánh giá: Tỉ lệ đặt NKQ có bóng chẹn phế quản thành công, mức độ xẹp phổi, thời gian đặt, áp lực cuff, mức độ đau rát họng sau mổ, tỉ lệ thiếu oxy sau đặt NKQ, đo ETC02 sau đặt NKQ. Kết quả: Chủ yếu bệnh nhân đều có cảm giác rát khó chịu vùng họng, tuy nhiên chủ yếu là ở mức thấp 3/10 (chiếm 60%). Trung bình thời gian đặt ống Nội khí quản có bóng chẹn ở bệnh nhân K thực quản là 25 phút. Trung bình mức độ xẹp phổi là bệnh nhân là 7,6/10. Kết luận: Đặt NKQ có bóng chẹn nhánh phế quản còn là một ứng dụng mới để gây mê thông khí một phổi cho phẫu thuật tạo hình thực quản do ung thư tại Bệnh viện Việt Đức, chúng tôi tạm đưa ra một số kết luận sau: Ưu điểm:Ống nội khí quản có bóng chẹn phế quản thực sự có hiệu quả với thông khí một phổi tạo phẫu trường rộng rãi thuận lợi cho phẫu thuật viên mổ tạo hình thực quản trong thì ngực. Không có thiếu oxy hay biến chứng khác nào được ghi nhận trong nghiên cứu của chúng tôi, không cần động tác thay ống nội khí quản khi chuyển sang thì bụng, sau mổ bệnh nhân ít đau rát họng hơn
Nhược điểm: Kĩ thuật mới nên đòi hỏi thời gian đặt nội khí quản lâu hơn, bác sỹ gây mê phải có kỹ năng dùng được nội soi khí quản ống mềm, có máy nội soi mềm hỗ trợ.Initial effective evaluation of endotracheal tube with a bronchial block ballon for single-lung ventilation in 10 adult patients undergoing surgery for esophageal cancer. Methods: Descriptive cross-sectional study. 10 adult patients with indications for anesthesia - surgery for esophageal cancer at Viet Duc hospital, from January 2021 to April 2022. Evaluation criteria: Successful intubation rate with bronchial block balloon cuff, degree of atelectasis, intubation time, cuff pressure, level of sore throat postoperation, post-intubation hypoxia rate, ETC02 measurement after intubation. Results: Most patients had an uncomfortable sensation in the throat, but it was mainly at a low level of 3/10 (accounting for 60%). The average time for endotracheal intubation with blockage baloon is 25 minutes. The average level of atelectasis in a patient is 7.6/10. Conclusion: Endotracheal tube with a bronchial block balloon is also a new application for anesthesia with single-lung ventilation for esophageal plastic surgery due to cancer at Viet Duc Hospital. We temporarily record some conclusions as follows: Advantages: Endotracheal tube with bronchial block is really effective for single-lung ventilation, creating a spacious surgical field convenient for surgeons performing esophageal reconstruction in the thoracic phase. There was no lack of oxygen or other complications recorded in our study. There was no need to change the endotracheal tube when transitioning to the abdominal phase. Postoperation, no complaints of sore throat
Disadvantages: The new technique requires longer intubation time, anesthesiologists must have skills in using flexible tracheal endoscopy, with support from a flexible endoscope.

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