新生儿Pierre Robin序列征牵引成骨术围手术期气道评估及管理

Assessment and management of difficult airways in neonates with Pierre Robin sequence

目的探讨新生儿Pierre Robin序列征（PRS）术前气道评估及合适的气道管理方法。方法根据18例患儿临床表现、体质量增长、呼吸困难及Cormack-Lehane分级进行评估并综合评分，观察评分与气管插管困难的关系。结果77％（14例）的患儿存在中度以上的气道梗阻，89％（16例）的患儿声门暴露困难，并由此导致气管插管困难（插管成功率50％）。结论通过对PRS患儿术前临床症状、体质量增长情况、呼吸困难严重程度及声门显露情况的综合评估，可预估困难插管。

Objective To assess the difficult airways preoperatively in neonates with Pierre Robin sequence （PRS）. Methods A total of 18 newborn PRS with difficult intubation were evaluated with the assessment grade. The scores were based upon clinical observation, weight gain, airway obstruction and Cormack-Lehane classification. Results A total of 14 neonates （77%） had medium （ n = 8 ） and severe （ n = 6） airway obstruction. And 89% （n = 16） failed to display glottis and unsuccessful tracheal intubation （50%）. Conclusion The assessment practice of clinical observation, weight gain, airway obstruction and Cormack-Lehane classification may help to identify the difficult airways in neonates with PRS.