气管、支气管手术围术期气道处理

Perioperative Airway Management in Tracheal and Bronchial Operations

本文报道1991年1月至1994年12月施行的气管、支气管手术50例。其中,气管环切4例,部分或全隆突切除4例,支气管袖状切除成形40例,外伤后主支气管断端吻合2例。术前肺功能检查,气管狭窄部位定位和程度估测,肺部包块大小及支气管受累情况,麻醉技术和方法的选择,术中气道保持通畅和充分供氧,术后呼吸监测,小剂量激素应用等是该类手术成功的关键问题。

From January 1991 to December 1994,50 patients with tracheal or bronchial resection and reconstruction were per- formed.These include tracheal resection (4 cases),partial or total tracheal carina resection (4),bronchial sleeve resection (40) and anastomosis of bronchial rupture (2cases). Pulmonary function evaluation,the site and degree of obstruction should be examined preoperatively.The anesthetic man- agement techniques,maintenance of airway arid provision of adequate ventilation during operation,postoperative respiratory care and low- dose steroids administration are the key points to success in these op- erations.