支气管封堵器的临床应用专家讲座

支气管封堵器的临床应用赵雪莲河北医科大学第四医院支气管封堵器的临床应用第1页支气管封堵器

-中国知网76；-支气管封堵器的临床应用第2页支气管封堵器

-中国知网支气管封堵器的临床应用第3页支气管封堵器的临床应用第4页支气管封堵器的临床应用第5页BronchialBlocker(BB)——PubMedClinicalTrial281996

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1/y支气管封堵器的临床应用第6页BronchialBlocker(BB)——PubMedCaseReport103人-102；动物-1。1983–支气管封堵器的临床应用第7页CaseReport支气管封堵器的临床应用第8页BBBB始于1936，Magill在胸科手术中使用末端带气囊长管封堵支气管，后改进与单腔气管导管配合使用。（带套囊尿管）现BB不停有新品面世。支气管封堵器的临床应用第9页BB类型Arndt

BBCohen

BBTCBUniventBBFuji

BBEZBBCoopdech

BB支气管封堵器的临床应用第10页BB：困难气道DLT的板凳队员Onelungventilationincaseswithunsuccessfuldouble-lumenendobronchialintubation.1993ChinesejournalofanesthesiologyIndependentplacementofabronchialblockerforsingle-lungventilation:analternativemethodforthedifficultairway.

1996Anesthesia&AnalgesiaUseoftheUniventSystemtubefordifficultintubationandforachievingone-lunganaesthesia.1996ActaAnaesthesiologicaScandinavicaLungisolationtechniquesforpatientswithdifficultairway.

CurrentopinioninanaesthesiologyOne-lungventilationinapatientwithstentingfortracheobronchialstenosiscausedbyesophagealcancer.

JournalofClinicalAnesthesiaUseoftheCoopdechBronchialBlockerasatrachealtubeintroducerinapatientwithdifficultlaryngoscopy.

JournalofClinicalAnesthesia支气管封堵器的临床应用第11页BB-小儿Anaestheticmanagementforaleftpneumonectomyinachildwithbronchopleuralfistula.PediatricAnesthesiaOne-lunganesthesiawassuccessfullymaintainedbymeansofFogartyCatheterininfant.

MasuiLungisolationinachildwithunilateralnecrotizingClostridiumperfringenspneumonia.

criticalcaremedicineCasereportofusingaconnector(phyconTCBbronchialblocker)forpediatricone-lunganesthesia.

MasuiSinglelungventilationinayoungchildforrepairofcoarctationofaorta.2010JournaloftheCollegeofPhysiciansandSurgeons--PakistanAlternativemethodsoflungisolationincasesofpediatricbilateralthoracoscopicsurgery

.

PediatricAnesthesia支气管封堵器的临床应用第12页BB-常规应用（单肺通气）BronchialBlocker

Versus

Left

Double-Lumen

EndotrachealTube

for

One-Lung

Ventilation

in

RightVideo-Assisted

Thoracoscopic

Surgery.

2018

JournalofCardiothoracicandVascularAnesthesiaLungIsolationforThoracicSurgery:FromInceptiontoEvidence-Based.

2017

ReviewJournalofCardiothoracicandVascularAnesthesiaAComparisonoftheEfficacyandAdverseEffectsofDouble-LumenEndobronchialTubesandBronchialBlockersinThoracicSurgery:ASystematicReviewandMeta-analysisofRandomizedControlledTrials.2015

JournalofCardiothoracicandVascularAnesthesiaAnupdateon

bronchial

blockersduringlungseparationtechniquesinadults.

2003

Anesthesia&Analgesia支气管封堵器的临床应用第13页BB-肺叶，肺段隔离SegmentalLungIsolationinaPostpneumonectomyPatientUndergoingContralateralLungResection.

2017JournalofCardiothoracicandVascularAnesthesiaLungisolationinpatientswithpreviouslungresections:SelectivesequentiallobarblockadeusingaFujiUniblocker®endobronchialblocker.2016

RevistaEspañoladeAnestesiologíayReanimaciónUpdateonselectivelobarblockadeduringpulmonaryresections.

2009

CurrentOpinioninAnesthesiologySequentiallobar-lung-lobarisolationusingadeflectingtipbronchialblocker.

2006

Journalofclinicalanesthesia支气管封堵器的临床应用第14页AProspectiveComparisonofIntraluminalandExtraluminalPlacementofthe9-FrenchArndtBronchialBlockerinAdultThoracicSurgeryPatients.

JournalofCardiothoracicandVascularAnesthesia

成人胸外科患者9-FArndt支气管阻封堵器腔内和腔外置入前瞻性比较。腔外方法放置时间显著缩短，术后喉咙痛发生率没有任何差异。不论是在腔内还是在腔外，大部分支气管内阻滞器最少需要一次术中重新定位。支气管封堵器的临床应用第15页BB-用于气管出血止血Useofbronchialblockerinemergentthoracotomyinpresenceofupperairwayhemorrhage,andcervicalspinefracture:adifficultdecision.

2018RevistaBrasileiradeAnestesiologiaExperienceofhemostasisintrachealbleedingveryclosetothecarinabythebronchialblocker:acasereport.2016KoreanJournalofAnesthesiologySuccessfulmanagementofatraumapatientwithpulmonaryhemorrhageusingawire-guidedbronchialblocker.

2007TheJournalofTrauma:Injury,Infection,andCriticalCare.BB-用于阻断单侧肺漏气Managementoftraumaticpneumothoraxwithmassiveairleakage:roleofabronchialblocker:acasereport.

2014KoreanJournalofAnesthesiologyBB治疗肺血栓取栓术后大咯血ManagementofMassiveHemoptysisAfterPulmonaryThromboembolectomyUsingaDoubleBronchialBlockerSystem.2017JournalofCardiothoracicandVascularAnesthesia支气管封堵器的临床应用第16页BB-支气管残端瘘Twosuccessfulcasesinthetreatmentofpost-operativebronchialstumpfistulae.

2005AnnalsofThoracicandCardiovascularSurgeryBB-气管切开后置入单肺通气ExtraluminalPlacementofanArndtBronchialBlockerThroughaTrachealStoma.

2016JournalofCardiothoracicandVascularAnesthesiaExsanguinatingtuberculosis-relatedhemoptysis:bronchialblockerintroducedthroughpercutaneoustracheostomy.

2009MinervaAnestesiologicaFoleycatheterusedasbronchialblockerforonelungventilationinapatientwithtracheostomy--acasereport.

1995ActaanaesthesiologicaSinicaBB-病态肥胖患者Lungseparation

inthe

morbidly

obese

patient.2012AnesthesiolResPractBB-气道巨大肿物Successfulone-lungventilationusingabronchialblockertubeforalargetrachealcarcinomaresection.2017JClinAnesth.支气管封堵器的临床应用第17页DLT+BBDLT复合BB

——肺感染肺叶切除Combinationofadouble-lumentrachealtubeandbronchialblockerforapatientwithcontinuousbleedingduetoinvasivelunginfection.

2015JournalofClinicalAnesthesiaDLT复合BB

——长期吸烟，气道分泌物多的肺叶切除AnestheticManagementofSimultaneousRightLobectomyandEsophagectomywithaDouble-lumenTrachealTubeand

Bronchial

Blocker.

2016MasuiDLT复合BB弥补DLT隔离不全Failureoflungisolationbyadouble-lumenendotrachealtuberescuedbytheconcomitantuseofanarndtbronchialblockerunderdirectvisualization.

2013A&ACaseReportsJournal支气管封堵器的临床应用第18页DLT+BBDLT复合BB

-——支气管胸膜瘘Lobar

bronchial

blockadeinbronchopleuralfistula.

1992AnesthesiologyDLT复合BB——肺毛霉菌病的单肺通气SuccessfulUseofaDoubleLumenEndotrachealTubeandBronchialBlockerforLungIsolationinPulmonaryMucormycosis.

2018JournalofCardiothoracicandVascularAnesthesiaDLT复合BB

——心外手术气道出血Bronchialblockerversusdouble-lumentubeforlungisolationwithmassivehemoptysisduringcardiacsurgery.

2013JournalofCardiothoracicandVascularAnesthesia支气管封堵器的临床应用第19页LM（laryngealmask）+BBLM+BB-DLT失败Differentiallungventilationusinglaryngealmaskairwayandabronchialblockertubeforapatientwithunanticipateddifficultintubation.

2007Masui.LM+BB–气道肿物Useoftheproseallaryngealmaskairwayandarndtbronchialblockerforlungseparationinapatientwithatrachealmassandaspirationrisk.2010JournalofCardiothoracicandVascularAnesthesiaLM+BB-气管切开Lungisolationusingalaryngealmaskairwayandabronchialblockerinapatientwitharecenttracheostomy.

2008JournalofCardiothoracicandVascularAnesthesia支气管封堵器的临床应用第20页不良事件BB尖端被切断TransectionofaCoopdechbronchialblockertipduringbronchialresectionforrightupperlobectomy:acasereport.

2015KoreanJournalofAnesthesiologyResectionoftheArndtBronchialBlockerduringstaplerresectionoftheleftlowerlobe.

2006

JournalofCardiothoracicandVascularAnesthesiaBB尖端扭转ThetipfractureoftheCoopdechbronchialblockerduringinsertioninthepatientwithlungsurgery.2014KoreanJournalofAnesthesiologyBB尖端折断AccidentalfractureofthetipoftheCoopdechbronchialblockerduringinsertionforonelungventilation.

2010

KoreanJournalofAnesthesiologyBB套囊破裂DifferentiallungventilationusingFogartycatheterafteraccidentaldamageofbronchialblockercuff.

1999MasuiABallooningCrisis:ThreeCasesofBronchialBlockerMalfunctionandAReview.2017JournalofCardiothoracicandVascularAnesthesiaAvulsionofabronchialblockercuffinthetracheawhenusingaParkerFlex-Tipendotrachealtube。2010JCardiothoracVascAnesth.

支气管封堵器的临床应用第21页BB-肺污染Casereport:pulmonarysoilingafterone-lungventilationwithabronchialblocker.

2002CanadianJournalofAnesthesiaBB低氧血症Severehypoxemiaaftersuctionofthenonventilatedlungviathebronchialblockerlumenoftheuniventtube.

1996JournalofCardiothoracicandVascularAnesthesiaBB

-严重低氧血症

Bronchial

blocker

for

one-lung

ventilation：A

unanticipated

complication2011

Indian

J

Anaesth气管支气管-应用BB失败Congenitaltrachealbronchus:theinabilitytoisolatetherightlungwithauniventbronchialblockertube.

2000AnesthesiaandAnalgesiaRightupperlobetrachealbronchus:anestheticchallengeinone-lungventilatedpatients-Areportofthreecases-.

2013KoreanJournalofAnesthesiology不良事件

支气管封堵器的临床应用第22页其他应用BB-取牙ExtractionofforeignbodywithArndt®bronchialblocker.2015RevistaEspañoladeAnestesiologíayReanimaciónBB-高频通气HighfrequencyjetventilationofonelungusingabronchialblockerofUniventduringcarinalresection.

2010

JournalofkoreanmedicalscienceHigh-frequencyjetventilationusingtheArndt

bronchial

blocker

forrefractoryhypoxemiaduringone-lungventilationinamyasthenicpatientwithasthma.

2014

JournalofclinicalanesthesiaBB–CPAP联合改善低氧Continuouspositiveairwaypressureappliedthroughabronchialblockerasatreatmentforhypoxemiaduetostenosisoftheleftmainbronchus.2009Anesthesiology支气管封堵器的临床应用第23页其他应用Gorham-Stout综合征：TheGorham-Stoutsyndrome:onelungventilationwithabronchialblocker.AcaseofGorham'sdiseasewithchylothorax.2009PediatricAnesthesia支气管扩张性骨软骨病Managementofonelungventilationwithbronchialblockercatheterforapatientwithtracheobronchopathiaosteochondroplastica.2007Masui微创CABGTheuseofabronchialblockercomparedwithadouble-lumentubeforsingle-lungventilationduringminimallyinvasivedirectcoronaryarterybypasssurgery.2002JCardiothoracVascAnesth.支气管封堵器的临床应用第24页E-Z

BBLungisolationusingEZ-Blockerbronchialblockinapatientduringabilateralendoscopicthoracicsympathectomy.2014RevistaEspañoladeAnestesiologíayReanimaciónSequentiallungisolationusingabronchialblocker(EZ-Blocker)forbilateraldorsalsympathectomy.

2013JournalofClinicalAnesthesiaSequentialbilaterallungisolationwithasinglebronchialblocker.

2013A&ACaseReportsJournal支气管封堵器的临床应用第25页UseofBronchialBlockersforLungIsolation.AnasthesiolIntensivmedNotfallmedSchmerzther

AComparisonoftheEfficacyandAdverseEffectsofDouble-LumenEndobronchialTubesandBronchialBlockersinThoracicSurgery:ASystematicReviewandMeta-analysisofRandomizedControlledTrials.

JournalofCardiothoracicandVascularAnesthesiaBB优点可用于幼儿实现叶、段萎陷易置入，气道损伤小进ICU不用换管缺点萎陷慢贵易移位有被闭合器切割危险DLT优点萎陷快费用低到位好缺点不可用于幼儿困难气道易失败支气管封堵器的临床应用第26页BB-定位听诊，光学探条和纤支镜PlacementoftheUniventtubewithoutfiberoptic