双腔支气管导管在胸腔手术中的应用进展
Advances in the Application of Double-Lumen Endobronchial Tubes in Thoracic Surgery
摘要: 双腔支气管导管(DLT)是成人胸腔手术中单肺通气的主流技术，其应用常面临插管困难、术中导管移位及相关并发症的挑战。解剖变异与导管尺寸选择不当可致插管困难及气道损伤，而手术体位变化易造成导管位置偏移，影响肺隔离效果与手术安全。本文综述关于提高DLT安全性的关键技术与方法：术前评估聚焦影像学与三维重建的个体化选管；操作技术探讨解剖导向插管、可视化设备及导管形态优化对定位的影响；术中管理分析动态监测技术的实时反馈价值及固定装置改良效果。通过整合循证医学证据与临床实践经验，为DLT的安全操作提供系统性理论支撑。
Abstract: The double-lumen endobronchial tube (DLT) remains the standard for achieving one-lung ventilation in adult thoracic surgery. Nevertheless, its application presents challenges including difficult intubation, intraoperative tube displacement, and associated complications. Anatomical variations and suboptimal tube sizing may lead to intubation difficulties and airway trauma, while positional changes during surgery often cause tube malposition—compromising lung isolation and operative safety. This review examines critical approaches to enhance DLT safety: preoperative strategies emphasizing individualized tube selection using advanced imaging and 3D reconstruction; intubation techniques incorporating anatomical guidance, visualization technology, and tube design modifications for optimal placement; and intraoperative management leveraging real-time dynamic monitoring feedback and improved fixation systems. By synthesizing evidence-based principles with clinical expertise, this work establishes a systematic theoretical foundation for the secure implementation of DLTs.
文章引用：李以晴, 赵鑫. 双腔支气管导管在胸腔手术中的应用进展[J]. 临床医学进展, 2025, 15(10): 749-755. https://doi.org/10.12677/acm.2025.15102815

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