The Effcts Of Two Endobronchial Intubation Methods In Patients Undergoing McKeown Surgery

[Objective] To compare the effect of left main bronchial intubation of Robertshaw double-chamber tracheal catheter under the guidance of fiberoptic bronchoscopy and visual double-chamber bronchial catheter(VDLT)on patients with Mc Keown surgery with thoracic esophageal cancer,so as to provide a certain theoretical and practical basis for the selection of tracheal intubation methods in such patients.[Methods] From September 2020 to September 2022,there were 40 patients with Mc Keown thoracic esophageal cancer,ASAI-Ⅱ,27 men,13 women,and 51-64 years old.According to the random number table method,it is divided into TF group and VD group(n=20).The TF group uses Robertshaw double-cavity tracheal catheter for left main bronchial intubation under the guidance of fiber bronchoscope,and VD group uses visual double-cavity bronchial catheter to use left main bronchial Record the general clinical data of two groups of patients and T1(preoperative),T2(immediately after intubation),T3(30min for single lung ventilation),T4(60min for single lung ventilation)and T5(30min after the recovery of double lung ventilation)time point hemodynamics(average arterial pressure and heart rate)and pulmonary Mark [oxygenation index(OI),respiratory index(RI)and intrapulmonary shunt rate(Qs/Qt)],and evaluate the time of intubation positioning,primary intubation success rate,catheter displacement rate and intubation-related complications.[Results] There was no significant difference in the preoperative general data of the two groups of patients and the pulmonary function-related indicators at each time point(P>0.05);except for the T2 time point VD group,the hemodynamic-related indicators of patients were significantly higher than that of the TF group(P<0.05),the hemodynamic-related indicators There is no significant difference(P>0.05).There is no significant difference in the catheter displacement rate between the two groups(P>0.05),but the success rate of one-time intubation of patients in the VD group was significantly lower than that of the TF group(P<0.05),In addition,4(20%)patients in the VD group had the lens blocked by airway secretions,of which 2(15%)patients failed to flush through the flushing channel and needed a fiber bronchoscope to locate again.[Conclusion] Both tracheal intubation methods can be safely used in patients with thoracic esophageal cancer under Mc Keown surgery.Robertshaw double-chamber tracheal catheter under the guidance of fiberoptic bronchoscopy has less impact on hemodynamics,and has more advantages in intubation,primary in place rate,incidence of intubation-related complications and medical costs.