病态肥胖症患者围手术期气道管理

Perioperative Airway Management for Patients with Morbid Obesity

病态肥胖患者头颈部和胸腹部脂肪组织异常堆积可导致上气道梗阻和呼吸功能受损,且患者往往存在阻塞性睡眠呼吸暂停、低通气综合征,慢性阻塞性肺疾病或哮喘等合并症,因此围手术期出现困难气道、术中通气不足、术后呼吸抑制等呼吸系统并发症的风险明显升高,给围手术期气道管理带来巨大挑战。麻醉医生深刻理解肥胖患者呼吸系统的病理生理特点,掌握合适的处理原则,对于提高重度肥胖患者围手术期麻醉管理的安全性和有效性,改善患者的临床预后至关重要。

The excess fatty tissues on the head,neck,thorax,and abdomen of morbid obese patients can impede the patency of the upper airway and impair lung functions.Meanwhile,these patients often have comorbidities such as obstructive sleep apnea,hypoventilation syndrome,chronic obstructive pulmonary disease,and asthma,which may result in difficult airway,intraoperative hypoventilation,and postoperative respiratory depression.Therefore,perioperative airway management for morbid obese patients may pose a big challenge to anesthesiologists.Anesthesiologists should know well about the pathophysiological features of respiratory system and grasp rational management principles,so as to improve the safety and effectiveness of perioperative airway management and optimize the clinical prognosis.