Comparison of selective lobobronchial block and main bronchial block in thoracoscopic surgery in children: a retrospective cohort study
10.3760/cma.j.cn112434-20230406-00076
- VernacularTitle:小儿胸腔镜手术中选择性肺叶支气管阻断与主支气管阻断的比较：一项回顾性队列研究
- Author:
Bo ZHAI
1
;
Xiangyang DONG
;
Zhenliang CHEN
;
Yingping JIA
;
Jie WANG
Author Information
1. 郑州大学附属儿童医院 河南省儿童医院郑州儿童医院胸心外科，郑州 450018
- Keywords:
Thoracoscopic surgery;
Pediatric surgery;
Selective lobar bronchial block;
Main bronchial block;
Hypoxemia;
Retrospective cohort study
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2024;40(2):89-93
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the difference between selective lobar bronchial block and main bronchial block in thoracoscopic surgery in children.Methods:A retrospective cohort study was conducted to analyze the clinical data of 150 children undergoing thoracoscopic surgery admitted to Henan Children's Hospital, Zhengzhou Children's Hospital, and Children's Hospital Affiliated to Zhengzhou University from December 2019 to December 2022. In the examination of the electronic medical record, 80 children were found to have selective lobar bronchial block, which was used as the study group, and 70 children were matched as the control group.Compare the general data of children in the two groups, such as age, gender, weight, surgical time, and other data. Compare the two groups with respect to hypoxemia, degree of pulmonary collapse, atelectasis, and number of bronchial blocker shifts. Compare the heart rate(HR), mean arterial pressure(MAP), degree of pulmonary collapse, and airway pressure(PAW) at different time points in the two groups[before single lung ventilation(OLV)(T1), 10 min after OLV(T2), and 10 min after OLV(T3)] Difference in alveolar arterial oxygen partial pressure(AaDO 2) levels. Results:Comparison of the incidence of hypoxemia, bronchial blocker displacement, and atelectasis in children in the study group were statistically significant( P<0.05). The results of repeated measurement of variance showed that there was statistically significant difference in the inter subject effects of HR and MAP levels at different time points between the two groups based on time factors( P<0.05). The results of repeated measurement of variance showed that there was statistical significance between the inter-subjective effects of the levels of PAW and AaDO 2 at different time points of the two groups with time factor as the source, group as the source, and intra-subjective effects with time and group interaction as the source( P<0.05). The levels of PAW and AaDO 2 in the study group at time points T2 and T3 were significantly lower than those in the control group, and the differences between the groups were statistically significant( P<0.05). Conclusion:The effect of selective lobobronchial blockade in thoracoscopic surgery in children is ideal, which can effectively improve the ventilation and related oxygenation of children, and reduce the occurrence of complications such as atelectasis and hypoxemia.
