小儿气管异物取出术麻醉呼吸管理方案综述

A review of anesthetic and breathing management on tracheobronchial foreign bodies in children

背景小儿气管异物是世界普遍存在的问题，异物导致的窒息是患儿意外死亡的主要原因。手术医师和麻醉医师共用气道，且在气道异物取出过程中易出现各种变化，麻醉风险较高，麻醉呼吸管理不善容易导致低氧血症、喉痉挛等并发症，增加患儿病死率。目的运用妥善的麻醉呼吸管理来配合气管镜下异物取出，保证患儿氧供充分，降低并发症发生率。内容搜集并整理近期国内外对气管异物取出术麻醉方法的进展，完善支气管镜下的各种麻醉呼吸管理方案。趋向麻醉医师可以根据自身经验及科室器材具备条件选择合适的麻醉呼吸管理方案，妥善实施麻醉，降低患儿病死率。

Background Aspiration of foreign bodies by children is a common problem around the world. Asphyxiation caused by foreign bodies is the major reason of accidental death. The anesthesiologists share airway with surgeons, and the changes vary easily during the removal of airway foreign bodies, so the risk of anesthesia is much higher. If anesthesia and respiration are not arranged probably, the complication such as hypoxemia or laryngospasm may occur. And the mortality of the patients increases. Objective The retrieval of foreign bodies needs well arranged anesthetic and airway management which can certify sufficient oxygen and reduce the rate of complications. Content By collecting and organizing the recent progress on anesthetic management about tracheobronchial foreign bodies both at home and abroad, we can improve and perfect the methods of anesthesia. Trend All anesthesiologists can choose proper anesthetic management according to their own experience and the equipment they have, and appropriate anesthesia to reduce mortality in children.