1、支气管封堵器的临床应用支气管封堵器的临床应用支气管封堵器支气管封堵器-中国知网中国知网76；2003-2018支气管封堵器支气管封堵器-中国知网中国知网Bronchial Blocker(BB)PubMedClinical Trial281996 20181/yBronchial Blocker(BB)PubMedCase Report103人人-102；动物；动物-1。1983 2018Case ReportBB BB 始于始于1936，Magill 在胸科手术中使用末端带气囊的长管在胸科手术中使用末端带气囊的长管封堵支气管，后改进与单腔气管导管配合使用。（带套囊封堵支气管，后改进与单腔气管
2、导管配合使用。（带套囊尿管）尿管）现现 BB 不断有新品面世。不断有新品面世。BB 类型类型Arndt BBCohen BBTCB Univent BBFuji BBE Z BB Coopdech BBBB：困难气道DLT 的板凳队员One lung ventilation in cases with unsuccessful double-lumen endobronchial intubation.1993 Chinese journal of anesthesiologyIndependent placement of a bronchial blocker for single-lun
3、g ventilation:an alternative method for the difficult airway.1996 Anesthesia&AnalgesiaUse of the Univent System tube for difficult intubation and for achieving one-lung anaesthesia.1996 Acta Anaesthesiologica ScandinavicaLung isolation techniques for patients with difficult airway.2010 Current opini
4、on in anaesthesiologyOne-lung ventilation in a patient with stenting for tracheobronchial stenosis caused by esophageal cancer.2011 Journal of Clinical Anesthesia Use of the Coopdech Bronchial Blocker as a tracheal tube introducer in a patient with difficult laryngoscopy.2010 Journal of Clinical Ane
5、sthesia BB-小儿Anaesthetic management for a left pneumonectomy in a child with bronchopleural fistula.2000 Pediatric AnesthesiaOne-lung anesthesia was successfully maintained by means of Fogarty Catheter in infant.2002 MasuiLung isolation in a child with unilateral necrotizing Clostridium perfringens
6、pneumonia.2005 critical care medicineCase report of using a connector(phycon TCB bronchial blocker)for pediatric one-lung anesthesia.2007 MasuiSingle lung ventilation in a young child for repair of coarctation of aorta.2010 Journal of the College of Physicians and Surgeons-Pakistan Alternative metho
7、ds of lung isolation in cases of pediatric bilateral thoracoscopic surgery.2016 Pediatric AnesthesiaBB-常规应用（单肺通气）Bronchial Blocker Versus Left Double-Lumen Endotracheal Tube for One-Lung Ventilation in Right Video-Assisted Thoracoscopic Surgery.2018 Journal of Cardiothoracic and Vascular Anesthesia
8、Lung Isolation for Thoracic Surgery:From Inception to Evidence-Based.2017 Review Journal of Cardiothoracic and Vascular Anesthesia A Comparison of the Efficacy and Adverse Effects of Double-Lumen Endobronchial Tubes and Bronchial Blockers in Thoracic Surgery:A Systematic Review and Meta-analysis of
9、Randomized Controlled Trials.2015 Journal of Cardiothoracic and Vascular AnesthesiaAn update on bronchial blockers during lung separation techniques in adults.2003 Anesthesia&AnalgesiaBB-肺叶，肺段隔离肺叶，肺段隔离Segmental Lung Isolation in a Postpneumonectomy Patient Undergoing Contralateral Lung Resection.201
10、7 Journal of Cardiothoracic and Vascular AnesthesiaLung isolation in patients with previous lung resections:Selective sequential lobar blockade using a Fuji Uniblocker endobronchial blocker.2016 Revista Espaola de Anestesiologa y ReanimacinUpdate on selective lobar blockade during pulmonary resectio
11、ns.2009 Current Opinion in AnesthesiologySequential lobar-lung-lobar isolation using a deflecting tip bronchial blocker.2006 Journal of clinical anesthesiaA Prospective Comparison of Intraluminal and Extraluminal Placement of the 9-French Arndt Bronchial Blocker in Adult Thoracic Surgery Patients.20
12、17 Journal of Cardiothoracic and Vascular Anesthesia 成人胸外科患者成人胸外科患者9-F Arndt支气管阻支气管阻封堵器封堵器腔内和腔外腔内和腔外置入置入的前瞻性比较的前瞻性比较。腔外腔外方法方法放置的时间显著放置的时间显著缩短缩短，术后喉咙痛术后喉咙痛的发生率没有任何差异的发生率没有任何差异。无论无论是在腔内还是在腔外是在腔内还是在腔外，大部分大部分支气管内阻滞支气管内阻滞器器至少需要一次术至少需要一次术中重新定位。中重新定位。BB-用于气管出血止血用于气管出血止血Use of bronchial blocker in emergent
13、thoracotomy in presence of upper airway hemorrhage,and cervical spine fracture:a difficult decision.2018 Revista Brasileira de AnestesiologiaExperience of hemostasis in tracheal bleeding very close to the carina by the bronchial blocker:a case report.2016 Korean Journal of Anesthesiology Successful
14、management of a trauma patient with pulmonary hemorrhage using a wire-guided bronchial blocker.2007 The Journal of Trauma:Injury,Infection,and Critical Care.BB-用于阻断单侧肺漏气用于阻断单侧肺漏气Management of traumatic pneumothorax with massive air leakage:role of a bronchial blocker:a case report.2014 Korean Journa
15、l of Anesthesiology BB 治疗肺血栓取栓术后大咯血治疗肺血栓取栓术后大咯血Management of Massive Hemoptysis After Pulmonary Thromboembolectomy Using a Double Bronchial Blocker System.2017 Journal of Cardiothoracic and Vascular AnesthesiaBB-支气管残端瘘支气管残端瘘Two successful cases in the treatment of post-operative bronchial stump fist
16、ulae.2005 Annals of Thoracic and Cardiovascular SurgeryBB-气管切开后置入单肺通气气管切开后置入单肺通气Extraluminal Placement of an Arndt Bronchial Blocker Through a Tracheal Stoma.2016 Journal of Cardiothoracic and Vascular AnesthesiaExsanguinating tuberculosis-related hemoptysis:bronchial blocker introduced through perc
17、utaneous tracheostomy.2009 Minerva AnestesiologicaFoley catheter used as bronchial blocker for one lung ventilation in a patient with tracheostomy-a case report.1995 Acta anaesthesiologica SinicaBB-病态肥胖患者病态肥胖患者Lung separation in the morbidly obese patient.2012 Anesthesiol Res PractBB-气道巨大肿物气道巨大肿物Suc
18、cessful one-lung ventilation using a bronchial blocker tube for a large tracheal carcinoma resection.2017 J Clin Anesth.DLT+BBDLT 复合复合 BB 弥补弥补 DLT 隔离不全隔离不全Failure of lung isolation by a double-lumen endotracheal tube rescued by the concomitant use of an arndt bronchial blocker under direct visualiza
19、tion.2013 A&A Case Reports JournalDLT 复合复合 BB 长期吸烟，气道分泌物多的肺叶切除长期吸烟，气道分泌物多的肺叶切除Anesthetic Management of Simultaneous Right Lobectomy and Esophagectomy with a Double-lumen Tracheal Tube and Bronchial Blocker.2016 MasuiDLT 复合复合 BB 肺感染肺叶切除肺感染肺叶切除Combination of a double-lumen tracheal tube and bronchial
20、blocker for a patient with continuous bleeding due to invasive lung infection.2015 Journal of Clinical AnesthesiaDLT+BBDLT 复合复合 BB 心外手术气道出血心外手术气道出血Bronchial blocker versus double-lumen tube for lung isolation with massive hemoptysis during cardiac surgery.2013 Journal of Cardiothoracic and Vascular
21、Anesthesia DLT 复合复合 BB肺毛霉菌病的单肺通气肺毛霉菌病的单肺通气 Successful Use of a Double Lumen Endotracheal Tube and Bronchial Blocker for Lung Isolation in Pulmonary Mucormycosis.2018 Journal of Cardiothoracic and Vascular AnesthesiaDLT 复合复合 BB -支气管胸膜瘘支气管胸膜瘘Lobar bronchial blockade in bronchopleural fistula.1992 Anes
22、thesiology LM（laryngeal mask）+BBLM+BB-DLT 失败失败Differential lung ventilation using laryngeal mask airway and a bronchial blocker tube for a patient with unanticipated difficult intubation.2007 Masui.LM+BB 气道肿物气道肿物Use of the proseal laryngeal mask airway and arndt bronchial blocker for lung separation
23、 in a patient with a tracheal mass and aspiration risk.2010 Journal of Cardiothoracic and Vascular AnesthesiaLM+BB-气管切开气管切开Lung isolation using a laryngeal mask airway and a bronchial blocker in a patient with a recent tracheostomy.2008 Journal of Cardiothoracic and Vascular Anesthesia不良事件BB 尖端被切断尖端
24、被切断Transection of a Coopdech bronchial blocker tip during bronchial resection for right upper lobectomy:a case report.2015 Korean Journal of AnesthesiologyResection of the Arndt Bronchial Blocker during stapler resection of the left lower lobe.2006 Journal of Cardiothoracic and Vascular AnesthesiaBB
25、 尖端扭转尖端扭转The tip fracture of the Coopdech bronchial blocker during insertion in the patient with lung surgery.2014 Korean Journal of AnesthesiologyBB 尖端折断尖端折断Accidental fracture of the tip of the Coopdech bronchial blocker during insertion for one lung ventilation.2010 Korean Journal of Anesthesiolo
26、gyBB 套囊破裂套囊破裂Differential lung ventilation using Fogarty catheter after accidental damage of bronchial blocker cuff.1999 MasuiA Ballooning Crisis:Three Cases of Bronchial Blocker Malfunction and A Review.2017 Journal of Cardiothoracic and Vascular AnesthesiaAvulsion of a bronchial blocker cuff in th
27、e trachea when using a Parker Flex-Tip endotracheal tube。2010 J Cardiothorac Vasc Anesth.BB-肺污染肺污染Case report:pulmonary soiling after one-lung ventilation with a bronchial blocker.2002 Canadian Journal of AnesthesiaBB 低氧血症低氧血症Severe hypoxemia after suction of the nonventilated lung via the bronchial
28、 blocker lumen of the univent tube.1996 Journal of Cardiothoracic and Vascular AnesthesiaBB -严重低氧血症严重低氧血症 Bronchial blocker for one-lung ventilation：A unanticipated complication2011 Indian J Anaesth气管支气管气管支气管-应用应用 BB 失败失败Congenital tracheal bronchus:the inability to isolate the right lung with a uni
29、vent bronchial blocker tube.2000 Anesthesia and AnalgesiaRight upper lobe tracheal bronchus:anesthetic challenge in one-lung ventilated patients-A report of three cases-.2013 Korean Journal of Anesthesiology不良事件不良事件其他应用BB-取牙取牙Extraction of foreign body with 2015 Revista Espaola de Anestesiologa y Re
30、animacinBB-高频通气高频通气High frequency jet ventilation of one lung using a bronchial blocker of Univent during carinal resection.2010 Journal of korean medical scienceHigh-frequency jet ventilation using the Arndt bronchial blocker for refractory hypoxemia during one-lung ventilation in a myasthenic pati
31、ent with asthma.2014 Journal of clinical anesthesiaBB CPAP 联合改善低氧联合改善低氧Continuous positive airway pressure applied through a bronchial blocker as a treatment for hypoxemia due to stenosis of the left main bronchus.2009 Anesthesiology其他应用其他应用Gorham-Stout综合征：综合征：The Gorham-Stout syndrome:one lung vent
32、ilation with a bronchial blocker.A case of Gorhams disease with chylothorax.2009 Pediatric Pediatric AnesthesiaAnesthesia支气管扩张性骨软骨病支气管扩张性骨软骨病Management of one lung ventilation with bronchial blocker catheter for a patient with tracheobronchopathia osteochondroplastica.2007 Masui微创微创CABGThe use of a
33、bronchial blocker compared with a double-lumen tube for single-lung ventilation during minimally invasive direct coronary artery bypass surgery.2002 J Cardiothorac Vasc Anesth.E-Z BBLung isolation using EZ-Blocker bronchial block in a patient during a bilateral endoscopic thoracic sympathectomy.2014
34、 Revista Espaola de Anestesiologa y ReanimacinSequential lung isolation using a bronchial blocker(EZ-Blocker)for bilateral dorsal sympathectomy.2013 Journal of Clinical AnesthesiaSequential bilateral lung isolation with a single bronchial blocker.2013 A&A Case Reports JournalUse of Bronchial Blocker
35、s for Lung Isolation.2018 Anasthesiol Intensivmed Notfallmed SchmerztherA Comparison of the Efficacy and Adverse Effects of Double-Lumen Endobronchial Tubes and Bronchial Blockers in Thoracic Surgery:A Systematic Review and Meta-analysis of Randomized Controlled Trials.2015 Journal of Cardiothoracic
36、 and Vascular Anesthesia可用于幼儿可用于幼儿实现叶、段萎陷实现叶、段萎陷易置入，气道损伤小易置入，气道损伤小进进 ICU 不用换管不用换管萎陷慢萎陷慢贵贵易移位易移位有被闭合器切割危险有被闭合器切割危险BB萎陷快萎陷快费用低费用低到位好到位好不可用于幼儿不可用于幼儿困难气道易失败困难气道易失败DLTBB-定位定位听诊，光学探条和纤支镜听诊，光学探条和纤支镜 Placement of the Univent tube without fiberoptic bronchoscope assistance.2010 A A 盲插、听诊盲插、听诊 Positioning of
37、the univent tube with bronchial blocker without fibreoptic bronchoscopy.2007 European Journal of Anaesthesiology ETCO2 Using the capnograph to confirm lung isolation when using a bronchial blocker.2010 Journal of Clinical Anesthesia气道峰压差气道峰压差气道峰压差值变化在支气管封堵器定位的应用气道峰压差值变化在支气管封堵器定位的应用.2018 临床肺科杂志临床肺科杂志
38、BB-加快加快萎陷萎陷50%,到单肺通气开始。到单肺通气开始。Bronchial blocker lung collapse technique:nitrous oxide for facilitating lung collapse during one-lung ventilation with a bronchial blocker.2014 Anesthesia and nesthesia and A AnalgesianalgesiaN2O:O2 断开断开60s，-30cmH2O,COPD 患者能明显缩短萎陷时间。患者能明显缩短萎陷时间。A comparison of the dis
39、connection technique with continuous bronchial suction for lung deflation when using the Arndt endobronchial blocker during video-assisted thoracoscopy:A randomised trial.2015 European Journal of Anaesthesiology负压抽吸负压抽吸+断开断开结结 论论Which device should be considered the best for lung isolation:double-lumen endotracheal tube versus bronchial blockers.Curr Opin Anaesthesiol.2007个体化个体化Evidence Base Surrounding Bronchial Blocker Use Continues to EvolveJournal of Cardiothoracic and Vascular Anesthesia 2018,Pages e14-e15Hilary P.Grocott,Canada重新认识重新认识BB
