患儿共享气道类手术气道管理研究进展

Research progress in airway management of pediatric shared airway surgery

共享气道类手术需要外科医师与麻醉科医师在同一气道解剖空间内实施操作及气道管理,围术期需要麻醉、外科和护理团队间保持密切沟通与合作。患儿上气道尤其狭窄,因病变种类多、对正常通气换气功能影响大,其共享气道手术的麻醉管理实施难度更大、风险更高,是临床麻醉的难点问题。在保障氧合与通气安全的基础上,尽可能为外科提供更好的视野暴露是共享气道工具开发及通气策略优化的目标。本文归纳总结了儿科共享气道类手术的种类与特点,重点分析非插管气道管理技术的应用范围和优缺点,以期为安全个性化地实施患儿共享气道的麻醉管理提供参考。

Surgeons and anesthesiologists perform operations and airway management in the same airway anatomy space in shared airway surgeries,and close communication and cooperation in anesthesia,surgical and nursing teams is required during perioperative period.The upper airway of children is especially narrow,with the variety of lesions and its great impact on the normal ventilation function,leading to more difficult implementation of anesthesia management and higher risks,which is a tough problem in clinical anesthesia.On the basis of ensuring the safety of oxygenation and ventilation,it is the goal of developing shared airway tools and optimizing ventilation strategies to provide better visual field exposure for surgery as much as possible.In this paper,the types and characteristics of pediatric shared airway surgery were summarized.The application scope,advantages and disadvantages of non-intubated airway management techniques were analyzed,in order to provide reference for the safe and personalized implementation of pediatric shared airway anesthesia management.