关键词: 支气管封堵器, 双腔支气管导管, 胸腔镜肺叶部分切除术, 肺萎陷评分

Abstract: Objective To compare the application effects of bronchial blocker (BB) and double-lumen endotracheal tube (DLT) in pediatric thoracoscopic lobectomy.Methods A total of 80 pediatric patients who underwent thoracoscopic lobectomy at Xuzhou Children’s Hospital from February 2020 to February 2023 were randomly divided into the DLT group (n=40) and the BB group (n=40) by envelope drawing.The DLT group received treatment with double-lumen endotracheal tubes,while the BB group was treated with bronchial blockers.Perioperative indicators,mean arterial pressure (MAP),heart rate (HR) at different times,airway pressure,pre- and post-operative recovery quality scores (QoR-15),intraoperative lung collapse (LCS) scores,modified Aldrete recovery scores,and adverse reactions were compared between the two groups.Results The comparison of single-lung ventilation time,intubation positioning time,and anesthesia time between the two groups showed no statistically significant differences (P>0.05);however,the operation time of the BB group was (68.37±6.28) minutes and the hospital stay was (4.56±0.35) days,while those of the DLT group were (76.87±8.34) minutes and (5.97±0.70) days,respectively.There was a statistically significant difference between the two groups (P<0.05).There were no significant differences in the mean arterial pressure (MAP) and heart rate (HR) before induction (T0) between the two groups (P>0.05).The MAP of the BB group immediately after intubation (T1),2 minutes after intubation (T2),immediately after extubation (T3),and 2 minutes after extubation (T4) was (91.53±8.28)mmHg,(89.58±8.72)mmHg,(89.33±8.97)mmHg,and (95.40±9.86)mmHg,respectively.The HRS were (72.74±6.35) times/minute,(72.83± 6.82) times/minute,(71.19±6.57) times/minute,and (73.63±7.46) times/minute respectively.The MAP in the DLT group was (83.88±7.29)mmHg,(83.40±7.66)mmHg,(85.17±7.91)mmHg,and (89.42±9.15)mmHg,respectively.HR was (66.68± 6.17) times/minute,(64.27±6.19) times/minute,(65.97±6.28) times/minute,and (68.80±6.27) times/minute,respectively.There was a statistically significant difference between the two groups (P<0.05).The airway pressures of the BB group at 5 minutes of bilateral lung ventilation (T5),5 minutes of unilateral lung ventilation (T6),and 5 minutes of recovery of bilateral lung ventilation (T7) were (14.36±2.46)cmH₂O,(17.34±2.75)cmH₂O,and (15.30 ± 2.32)cmH₂O,respectively.The values in the DLT group were (17.77±2.85)cmH₂O,(21.35±3.17)cmH₂O,and (18.49±2.99)cmH₂O,respectively.There was a statistically significant difference between the two groups (P<0.05).There was no statistically significant difference in QOR-15 score and modified Aldrete recovery score one day before the operation between the two groups (P>0.05).One day after surgery,the QOR-15 score of the BB group was (119.33±12.20) points,and the intraoperative LCS score was (7.70±0.61) points,while those of the DLT group were (107.60±10.10) and (6.31±0.57) points,respectively.There was a statistically significant difference between the two groups (P<0.05).The incidence of adverse reactions was 10.0% in the BB group and 27.5% in the DLT group.There was a statistically significant difference between the two groups (P< 0.05).Conclusion The application of bronchial blockers in pediatric thoracoscopic lobectomy shows better results compared to double-lumen endotracheal tubes.

Key words: bronchial blocker, double-lumen endotracheal tube, thoracoscopic lobectomy, lung collapse score