目的:观察3种气管插管术在胸腹腔镜食管癌根治术中的应用。方法:选取郑州大学附属肿瘤医院2019年2至9月择期全麻下行胸腹腔镜食管癌根治术患者180例，采用随机数字表法分为3组（n n=60）：双腔气管插管组（S组）、单腔气管插管组（D组）、Coopdech封堵支气管导管联合单腔气管插管组（C组）。采集患者气管插管完成即刻（Tn 0）、人工气胸开始后（单肺通气）30 min（Tn 1）、人工气胸结束后（双肺通气）30 min（Tn 2）、拔管后30 min（Tn 3）的动脉血，检测并分析3组患者动脉血气指标的差异；记录并比较3组患者各个时间点的心率（HR）、血氧分压（PaOn 2）、血二氧化碳分压（PaCOn 2）及气道压（Paw）；分析3组患者气管插管术完成时间、COn 2胸内充气压力、肺萎陷程度、术后3 d肺炎发生率的差异。采集患者Tn 0、Tn 2、手术结束（Tn 4）支气管肺泡灌洗液（BALF），应用酶联免疫吸附法（ELISA）检测BALF中肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）、白细胞介素8（IL-8）的水平，并进行比较分析。n 结果:手术过程中一共剔除14例患者，其中9例手术时间超过6 h，3例术中出现心律失常，2例手术时间少于1 h。最终S组56例、D组54例、C组56例完成试验。S组、D组、C组患者肺萎陷满意率分别为85.7%（48/56）、100.0%（54/54）、89.2%（50/56），差异无统计学意义（χ2=1.308，n P>0.05）；D组患者COn 2胸内充气压力为（10.2±2.2）mmHg（1 mmHg=0.133 kPa），高于S组、C组的（5.1±3.4）和（5.6±3.1）mmHg （n F=-9.303，n P<0.05）；D组患者术后3 d肺炎发生率为14.8%，低于S组、C组的39.3%和17.8%（χ2=8.300，n P<0.05）。Tn 4时D组患者TNF-α值为（122.4±4.4）ng/L，低于S组、C组的（257.9±6.3）和（185.8±5.6）ng/L（n F= 69.020，n P<0.05）；Tn 4时D组患者IL-6值为（175.4±4.9）ng/L，低于S组、C组的（289.6±6.8）和（226.2±4.4）ng/L，差异有统计学意义（n F=59.750，n P<0.05）；Tn 4时D组患者IL-8值为（303.1±7.2）ng/L，低于S组、C组的（595.4±22.1）和（436.8±10.9）ng/L（n F=55.359，n P0.05). The intrathoracic inflation pressure of carbon dioxide in group D was (10.2±2.2) mmHg (1 mmHg=0.133 kPa), which was higher than (5.1±3.4) mmHg in group S and (5.6±3.1) mmHg in group C, the difference was statistically significant (n F=-9.303, n P<0.05). The incidence of postoperative 3-day pneumonia in group D was 14.8%, which was lower than 39.3% in group S and 17.8% in group C, the difference was statistically significant (χ2=8.300, n P<0.05). At Tn 4, the value of TNF-α in group D was (122.4±4.4) ng/L, which was lower than that in group S and group C, (257.9±6.3) and (185.8±5.6) ng/L, with statistically significant difference (n F=69.020, n P<0.05). At Tn 4, the value of IL-6 in group D was (175.4±4.9) ng/L, which was lower than that of patients in group S and group C, (289.6±6.8) and (226.2±4.4) ng/L, with statistically significant difference (n F=59.750, n P<0.05). At Tn 4, the value of IL-8 in group D was (303.1±7.2) ng/L, which was lower than in group S and group C, (595.4±22.1) and (436.8±10.9) ng/L, with statistically significant difference (n F=55.359, n P<0.05).n Conclusion:All the three endotracheal intubations can produce satisfactory ventilation effect in the combined thoracoscopic and laparoscopic esophagectomy, however, single-lumen endotracheal intubation has less effect on lung injury.