口腔颌面肿瘤手术麻醉气道管理

Airway management under general anesthesia during operation for oral and maxillofacial tumors

口腔颌面部肿瘤通常需要在全身麻醉下实施手术。口腔颌面部血运丰富,手术时创伤大、出血量多,术后组织肿胀、颌颈部包扎固定及分泌物残留等,以及肿瘤作用,从而影响呼吸道通畅,严重时可引起急性上呼吸道窒息,甚至危及患者生命。因此,做好口腔颌面部肿瘤围手术期的呼吸道管理,确保呼吸道通畅是保证该手术成功的关键。本文系统阐述口腔颌面肿瘤手术的麻醉准备、气管内插管、并发症预防等,以有效保证手术过程的气道通畅。临床实践证明,口腔颌面肿瘤手术麻醉过程良好的气道管理是保证围手术期患者生命安全的重要环节,因为这些环节与手术的成败密切相关。

General anesthesia is usually required in per-forming operation for oral and maxillofacial tumors. The maxil-lofaeial region has rich blood supply, and the surgical opera-tion targeting to this region is generally accompanied by majorsurgical trauma and large blood loss. Maxiilofaeial tumors of-ten affect the airway, which, together with postoperative swell-ing,jaw and neck bandaged fixation, as well as secretions resi-due, is unfavorable to keep the airway unobstructed, even leads to acute upper respiratory tract suffocation, and endan-gers the patient's life. Therefore, it is crucial to monitor the re-spiratory tract and keep the respiratory tract unobstructed dur-ing perioperative period. It plays a key role in guaranteeing the success of the operation and safety of patients. We systemati-cally reviewed the methods of airway management during oral and maxillofacial operation in several aspects, such as the pre-anesthesia preparation, endotracheal intubation, compli-cations and points for attention, etc. Clinical practice has proved that airway management in the perioperative period is very important to ensure the safety of patient' s life. It is close-ly associated with the success of the operation manipulation.