小儿气道管理现状与展望

Present situation and prospect of airway management in children

小儿气道管理是每个麻醉医生都必须掌握的技能,同时也是一项挑战。小儿气道并不是缩小了的成人气道,其独特的解剖、生理、病理变化,使其管理更加复杂和困难。现主要的管理方法有面罩通气、气管插管和喉罩。不同的病人特点和不同的操作要求可选择不同的气道管理方法,其各有利弊。对小儿困难气道常采用吸入麻醉下保留自主呼吸插入气管导管或喉罩,辅助设备有可视喉镜、纤维支气管镜。虽然新技术和新设备的不断发展已改善了小儿气道管理的窘境,但仍需不断地探索来满足更多的气道管理需求,降低并发症,提高成功率。

Pediatric airway management is a required skill and a challenge for every anesthesiologist.The pediatric airway is not a narrowing of the adult airway.The unique anatomic,physiological and pathological changes make it more complex and difficult to manage.The main management methods include mask ventilation,endotracheal intubation and laryngeal mask.Different airway management methods can be chosen according to different patient characteristics and different operation requirements.Each method has its advantages and disadvantages.In children with difficult airway,the method is often used to keep spontaneous breathing and insert the endotracheal tube or laryngeal mask under inhalation anesthesia.The auxiliary equipments are visual laryngoscope and fiberoptic bronchoscope.Although the development of new technologies and equipments have improved the dilemma of airway management in children,it is still necessary to continuously explore to meet the more needs of airway management,reduce complications and improve the success rate.