困难气道患者的拔管策略

Strategies for extubation of the difficult airway

背景困难气道患者拔管失败率相对较高，易出现严重的并发症。目的对于困难气道患者，拔管前进行充分的气道评估，制定安全、可控的拔管策略非常重要。内容重点介绍了困难气道或可疑困难气道患者拔管前的气道评估，以及针对不同的困难气道患者所应该采取的拔管处理策略。趋向困难气道患者拔管前应该进行全面的气道评估，熟悉困难气道插管、拔管的操作流程、掌握气管导管交换器等困难拔管工具的操作技术以及插管失败后其他的可能选择，以提高困难气道患者围拔管期的安全。

Background The extubation failure of difficult airway is relatively high, and often results in serious complications. Objective It is very important to fully examine the airway and formulate safe and reversible extubation strategies before extubation. Content This review focuses on the evaluation of a known or suspected difficult airway and strategies for its extubation. Trend For patients with difficult airway, sufficient and thoroughly airway evaluation is very necessary betbre extubation. One should be familiar with the algorithms of intubation and extubation of a difficult airway, the techniques of airway exchange catheter and other auxiliary tool for the extuhation.