Wu Yuchen, Liu Yatao, Ruan Han, Zhang Zhigang, Yang Junfen, Li Ning, Wang Guoqiang, Wang Xin
First Hospital of Lanzhou University, Lanzhou, 730000, China.
Research Institution for "Ren" Doctors, China Medical University, Shenyang, 110122, China.
BMC Anesthesiol. 2025 May 31;25(1):281. doi: 10.1186/s12871-025-03144-5.
To compare the efficiency and safety of double-lumen bronchial tube (DLBT) and bronchial blocker (BB) for one-lung ventilation (OLV) in patients with thoracic surgery.
A systematic search was conducted across Chinese databases and English databases from the inception of the databases until December 31, 2024. Two researchers independently screened the literature and extracted data. A meta-analysis was then performed using Review Manager 5 and Stata 18.0 software. The quality of the studies was assessed using the Cochrane bias risk assessment tool, and a summary of findings (SoF) table was generated using GRADEprofiler Version 3.6.1.
A total of 39 RCTs were included, comprising 1360 patients in the BB group and 1349 patients in the DLBT group. The excellent rate of lung collapse quality in the BB group was 0.94 times that in the DLBT group [I = 32%, P = 0.07, fixed-effects; RR = 0.94; 95% CI (0.90, 0.99); P = 0.01]. There was no significant difference in intubation time [I = 97%, P < 0.00001; SMD = -0.51; 95% CI (-1.17, 0.14); P = 0.12], the success rate of first-attempt intubation [I = 79%, P < 0.00001; RR = 1.04; 95% CI (0.93, 1.15); P = 0.51] or in the incidence of malposition[I = 50%, P = 0.01; RR = 1.36; 95% CI (0.95, 1.96); P = 0.10)] between the two groups. However, there was a significant difference in positioning time, with the BB group showing shorter positioning times compared to the DLBT group [I = 98%, P < 0.00001; SMD = -0.85; 95% CI (-1.50, -0.21); P = 0.004]. Compared to the DLBT group, the BB group was associated with a reduced incidence of hoarseness, sore throat, tracheal mucosal injury, hypoxemia, and pneumonia.
The DLBT group demonstrated certain advantages in terms of lung collapse time and quality of lung collapse. However, BB demonstrate significantly shorter positioning time compared to DLBT, and it is also associated with lower risks of multiple complications, including hoarseness, sore throat, tracheal injury, hypoxemia, and pneumonia, highlighting its safety advantage in postoperative care.
比较双腔支气管导管（DLBT）和支气管封堵器（BB）在胸外科手术患者单肺通气（OLV）中的有效性和安全性。
从数据库建立至2024年12月31日，在中国数据库和英文数据库中进行系统检索。两名研究人员独立筛选文献并提取数据。然后使用Review Manager 5和Stata 18.0软件进行荟萃分析。采用Cochrane偏倚风险评估工具评估研究质量，并使用GRADEprofiler 3.6.1版生成结果总结（SoF）表。
共纳入39项随机对照试验，BB组1360例患者，DLBT组1349例患者。BB组肺萎陷质量优良率是DLBT组的0.94倍[I² = 32%，P = 0.07，固定效应模型；RR = 0.94；95%可信区间（0.90，0.99）；P = 0.01]。两组在插管时间[I² = 97%，P < 0.00001；标准化均数差（SMD）= -0.51；95%可信区间（-1.17，0.14）；P = 0.12]、首次插管成功率[I² = 79%，P < 0.00001；RR = 1.04；95%可信区间（0.93，1.15）；P = 0.51]或错位发生率[I² = 50%，P = 0.01；RR = 1.36；95%可信区间（0.95，1.96）；P = 0.10]方面无显著差异。然而，在定位时间上存在显著差异，BB组的定位时间比DLBT组短[I² = 98%，P < 0.00001；SMD = -0.85；95%可信区间（-1.50，-0.21）；P = 0.004]。与DLBT组相比，BB组声音嘶哑、咽痛、气管黏膜损伤、低氧血症和肺炎的发生率降低。
DLBT组在肺萎陷时间和肺萎陷质量方面显示出一定优势。然而，与DLBT相比，BB的定位时间明显更短，并且其多种并发症的风险也更低，包括声音嘶哑、咽痛、气管损伤、低氧血症和肺炎，突出了其在术后护理中的安全优势。
