Objective To compare the performance between bronchial blocker and double - lumen tube in patients during one - lung ventilation and their effects on inflammatory factors. Method 60 patients undergoing video - assisted thoracic surgery were randomly divid-ed into group R(double - lumen tube,DLT)and group C(bronchial blocker,BB). And group R were divided into R1(group left - sided DLT)and R2(group right - sided DLT)according to different lung separation,group C were divided into C1(group left BB)and C2 (group right BB)also according to different lung isolation techniques,each group had 15 cases. The data was recorded:intubation location time,the number of tube disposition,the quality of lung collapse. Recorded the hemodynamic changes at the following time:before intuba-tion,after intubation location immediately,2 min after intubation location. Recorded peak airway pressure before and after one - lung ventila-tion. Arterial blood were drew to measure blood gas analysis,records PaCO2 and PaO2 before one - lung ventilation and OLV 45 min. The number of postoperative hoarseness and sore throat was assessed after 2 days. Arterial blood was took to measure tumor necrosis factor - a (TNF - a)interleukin - 6(IL - 6)before venous induced anesthesia and OLV 45 min. Results Intubation location time was significantly longer in group R2 than that in group C1 、group C2 and group R1(P < 0. 05),C1、C2、R1 groups were no difference(P > 0. 05). 7 patients who were found tube disposition in group R2 were more than C1、C2、R1 three groups,but there were no difference in C1、C2、R1 three groups(P > 0. 05). 5 patients who were excellent and 9 patients who were better in group R2 on the quality of lung collapse were difference than C1、C2、R1 three groups(P < 0. 05),only 1 patients who was bad was no statistically significant than C1、C2、R1 three groups(P >0. 05). Peak airway pressure before OLV was no difference in group C1 and group C2(P > 0. 05),higher than that in group R1 and group R2(P < 0. 05). And peak airway pressure in group R1 and group R2 was higher than group C1 and group C2 after OLV(P < 0. 05). MAP and HR in group R1 and group R2 before intubation location were increased than that after intubation location immediately,2 min after intu-bation location(P < 0. 05),which were no difference in group C1 and groupC2(P > 0. 05). MAP and HR in group R1、R2 were higher than that in group C1、C2 at the same intubation point(P < 0. 05). PaO2 in four groups before OLV was lower than that at OLV 45 min(P <0. 05). No significant changes were found among four groups at OLV 45 min(P > 0. 05). PaCO2 in four groups before OLV was no differ-ence than that at OLV 45 min(P > 0. 05). The number of postoperative hoarseness and sore throat were no difference after 2 days between group C1 and group C2(P > 0. 05),between group R1 and group R2(P > 0. 05),which in group C1 、C2 were significantly lower than that in group R1、R2 after postoperative 2 days(P < 0. 05). TNF - a and IL - 6 at OLV 45 min were significantly higher in group R1 than that before venous induced anesthesia in four groups(P < 0. 05). While TNF - a and IL - 6 were higher in group R1、R2 than that in group C1、C2 at OLV 45 min(P < 0. 05). Conclusion Bronchial blocker used in one - lung ventilation can take little effect on hemodynamics,pro-vide lower airway resistance and exact lung collapse,reduce the incidence of postoperative hoarseness and sore throat than double - lumen tube. Also bronchial blocker may accurately,fast and conveniently locate,especially the right double - lumen tube. And bronchial blocker has a smaller influence on inflammation factors. Maybe it could be successfully intubate and locate,be less tube displacement. However,the inflammatory factors caused by many reasons,we should makes further study.%目的：比较支气管阻塞管和双腔管在单肺通气手术中应用的临床效果和对炎性细胞因子的影响。方法：选择胸腔镜手术患者60例，随机分为 R 组（双腔管组）和 C 组（支气管阻塞管组）。然后根据阻隔肺不同，将 R 组分为 R1组（左侧双腔管），R2组（右侧双腔管），又将 C 组分为 C1组（左侧支气管），C2组（右侧支气管），每组15例。记录插管定位时间、导管移位例数、肺萎陷的质量；记录单肺通气前和单肺通气后气道峰压；单肺通气前、单肺通气45 min 测定血气分析；观察术后2天咽喉疼痛、声音嘶哑发生的情况；在麻醉诱导前、单肺通气45 min 测定肿瘤坏死因子- a、白细胞介素-6。结果：插管定位时间 R2组比C1、C2、R1三组患者的时间长（P <0.05），C1、C2、R1三组患者比较，差异无统计学意义（P >0.05）；R2组导管移位7例，比 C1、C2、R1三组患者移位的多（P <0.05），C1、C2、R1三组患者比较，差异无统计学意义（P >0.05）；R2组肺萎陷质量有5例为优，9例为良，与 C1、C2、R1三组比较，差异有统计学意义（P <0.05）；OLV 后 C 组气道峰压比 OLV 前无明显升高（P >0.05），R 组气道峰压显著升高（P <0.05）；C 组术后咽痛声嘶发生率明显低于 R 组（P <0.05）；OLV 45 min 时四组患者的 TNF - a、IL -6与麻醉诱导前比较均有明显升高（P <0.05），OLV 45 min 时四组患者的 TNF - a、IL -6相比：R1、R2组比 C1、C2组明显升高（ P <0.05）。结论：支气管阻塞管比双腔管气道阻力低，肺萎陷好，术后咽痛声嘶等并发生症发生率低。并且支气管阻塞管定位准确、快捷、方便，尤其比右侧双腔管优势明显。支气管阻塞管对炎性因子影响小，可能与插管、定位顺利，导管移位较少有关。但影响炎性因子的因素较多，有待进一步研究。
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