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例1 男,37岁,因反复大咯血、意识不清伴面部紫绀0.5h于2001年9月17日急诊入院。入手术室时血压为40/10mm Hg(1mm Hg=0.133kPa),心事30～40次/min。立即行右侧股静脉穿刺置管建立静脉通道,紧急插入双腔支气管导管。插管同时,因呼吸心跳骤停,即刻静脉注射肾上腺素、阿托品后,心跳恢复。予麻醉机供氧,并加压输血输液纠正休克,同时交替吸出左、右支气管管腔内血液及分泌物。因见左侧管腔不断有血液溢出,而右侧管腔血液逐渐减少,判断血液来自左肺,故在静吸复合全麻下行左侧开胸探查术,术中见左下肺支气管扩张,行左下肺叶切除术。在患者术后意识、自主呼吸恢复情况下,拔除双腔支气管导管,送入重症监护病房(ICU)治疗,10d后痊愈出院。 例2 女,24岁,因复发性大咯血、极度呼吸困难伴昏迷1h于2002年3月6日急诊入院。入手术室时血压50/20mm Hg,心率146次/min,快速插入双腔支气管导管,于静脉
Example 1 Male, 37 years old, due to repeated massive hemoptysis, unconsciousness with facial cyanosis 0.5h on September 17, 2001 emergency admission. Into the operating room when the blood pressure 40 / 10mm Hg (1mm Hg = 0.133kPa), 30 to 40 beats / min. Right venous femoral vein catheterization immediately set up venous access, emergency insertion of double lumen bronchial catheter. Intubation at the same time, due to respiratory arrest, immediate intravenous epinephrine, atropine, the heartbeat recovery. To the anesthesia machine oxygen, and pressure transfusion fluid to correct shock, while alternately sucking left and right bronchial lumen of blood and secretions. See the left lumen continuous blood spill, and the right lumen blood gradually reduced to determine the blood from the left lung, so in the static suction under general anesthesia underwent thoracotomy, surgery, see the left lower lung bronchiectasis, line Left lower lobe resection. In patients with postoperative consciousness, spontaneous breathing recovery cases, removal of double lumen bronchial catheter, into intensive care unit (ICU) treatment, discharged after 10d. Example 2 Female, 24 years old, admitted to emergency department on March 6, 2002 due to recurrent hemoptysis and extreme dyspnea with coma 1 h. Into the operating room when the blood pressure 50 / 20mm Hg, heart rate 146 times / min, rapid insertion of double lumen bronchial catheter in the vein