双腔支气管导管规格型号的选择和插管方法应用进展  

Advances in the selection of sizes and application of intubation methods of double‑lumen tube

作　　者：张琬恬 王睿轩 张玉 古诗瑶 雷迁 曾思 Zhang Wantian;Wang Ruixuan;Zhang Yu;Gu Shiyao;Lei Qian;Zeng Si(Department of Anesthesiology,Sichuan Academy of Medical Sciences,Sichuan Provincial People's Hospital(Affiliated Hospital of University of Electronic Science and Technology of China),Chengdu 610072,China;School of Medical and Life Sciences,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China)

机构地区：[1]四川省医学科学院·四川省人民医院(电子科技大学附属医院)麻醉科,成都610072 [2]成都中医药大学医学与生命科学学院,成都611137

出　　处：《国际麻醉学与复苏杂志》2024年第12期1297-1302,共6页International Journal of Anesthesiology and Resuscitation

基　　金：国家自然科学基金(82202071);国家卫生健康委人才交流服务中心基金(RCLX2315027);四川省科技厅计划项目(2023YFS0036)。

摘　　要：双腔支气管导管(DLT)是胸腔镜手术及纵隔手术中隔离双肺、行单肺通气的重要工具,具有避免纵隔摆动、避免分泌物流入健侧、便于外科手术操作等优点,在胸外科手术麻醉中广泛应用。为了解决DLT插管时可能会出现的导管尺寸不合、对位不良等问题,麻醉医师提出了多种提高插管成功率的方法,如借助术前检查评估支气管大小并选择合适的DLT、多种改良的插管方法和插管工具等。文章总结了DLT插管有关CT、X线、超声及3D打印评估气道的方法,以及可能使用的插管方法和可视化工具,旨在为麻醉医师进行DLT插管时提供更多选择,降低DLT错位率,促进DLT临床应用的改良及发展。The double‑lumen tube(DLT)is a critical tool for isolating both lungs and enabling single-lung ventilation during thoracoscopic and mediastinal surgeries.It offers advantages such as avoiding mediastinal swing,preventing secretion inflow to the healthy lung,and facilitating surgical procedures,making it widely used in anesthesia for thoracic surgery.To address issues related to DLT size mismatch and suboptimal positioning during intubation,anesthesiologists have proposed various strategies to improve intubation success rates.These include evaluating bronchial size through preoperative examinations and selecting the appropriate DLT,along with employing various enhanced intubation techniques and tools.This review summarizes methods for assessing the airway related to DLT intubation using CT,X‑ray,ultrasound,and 3D printing,as well as discussing potential intubation techniques and visualization tools.The goal is to provide anesthesiologists with more options for DLT intubation,reduce the incidence of DLT malpositioning,and facilitate the improvement and development of DLT's clinical applications.

关 键 词：双腔支气管导管 型号 插管术 气道评估 可视化 

分 类 号：R61[医药卫生—外科学]