Brodsky Jay B
Department of Anesthesiology, Stanford University School of Medicine, Stanford, California 94305, USA.
Curr Opin Anaesthesiol. 2004 Feb;17(1):7-11. doi: 10.1097/00001503-200402000-00003.
The debate continues as to whether a fiberoptic bronchoscope must be used to position a double-lumen tube. This review supports the argument that although bronchoscopy is extremely helpful, it is not always needed for the routine placement of left double-lumen tubes.
Several recent clinical reports have demonstrated that an experienced anesthesiologist can safely and consistently position double-lumen tubes without bronchoscopic assistance. In order to do so several important factors must be considered. These include the appropriate choice of tube (left or right), size of tube, and endpoint for the depth of insertion.
Although bronchoscopy is useful, no double-lumen tube positioning method is fail-safe. The choice of which approach to use, 'blind' versus fiberoptic bronchoscope-assisted, is influenced by many factors. Operator experience with any method increases the likelihood of success. A fiberoptic bronchoscope is not always needed for left double-lumen tube placement.
关于是否必须使用纤维支气管镜来放置双腔管的争论仍在继续。本综述支持以下观点：尽管支气管镜检查非常有帮助，但常规放置左双腔管并非总是需要它。
最近的几份临床报告表明，经验丰富的麻醉医生可以在无需支气管镜辅助的情况下安全且一致地放置双腔管。为了做到这一点，必须考虑几个重要因素。这些因素包括导管的合适选择（左或右）、导管尺寸以及插入深度的终点。
尽管支气管镜检查很有用，但没有一种双腔管定位方法是万无一失的。选择“盲插”还是纤维支气管镜辅助的方法会受到许多因素的影响。操作者对任何一种方法的经验都会增加成功的可能性。放置左双腔管并非总是需要纤维支气管镜。
