新生儿先天性食管闭锁围手术期气道管理的研究

Study on Airway Management of Neonates with Congenital Esophageal Atresia during Perioperative Period

目的总结我院近年来收治的36例新生儿先天性食管闭锁围手术期气道管理方法,为今后的临床实践提供参考及指导。方法对2015年2月至2020年2月收住本院36例拟进行手术治疗食管闭锁新生儿纳入研究。对所有纳入研究的新生儿实施围手术期气道管理,通过持续、间断的食管盲端负压吸引、有效吸痰、合理供氧、应用抗生素及控制肺炎、加强保暖,实施气管导管护理、湿化气道及正确吸痰、实施胸部理疗等气道管理方式,保证新生儿气道安全,促进患儿围手术期康复。结果36例食管闭锁新生儿均实施气管内全身麻醉经气管食管瘘结扎术治疗,其中35例成功完成康复出院,成功率为97.22%,余1例围手术期死亡,病死率2.78%。术后发生1例肺炎肺不张,其余病例术后未见并发症。结论实施新生儿先天性食管闭锁围手术期气道管理,可提升新生儿手术的安全性,降低围手术期并发症,促进新生儿术后早期康复。

Objective To summarize the perioperative airway management of 36 neonates with congenital esophageal atresia in our hospital in recent years,to provide reference and guidance for future clinical practice.Methods A total of 36 cases of newborns with esophageal atresia who were admitted to our hospital from February 2015 to February 2020 were studied.Perioperative airway management for all neonates included in the study,through continuous and intermittentsuction of negative pressure at the blind end of esophagus,effective sputum suction,rational oxygen supply,application of antibiotics and control of pneumonia,to implement airway management methods such as tracheal catheter nursing,humidification of airway,proper sputum aspiration,chest physiotherapy,to ensure neonatal airway safety,to promote the perioperative rehabilitation of children.Results All 36 neonates with esophageal atresia weretreated with endotracheal general anesthesia,of these,35 were successfully discharged,the success rate was 97.22%,one case remaining perioperative death,mortality rate 2.78%.One case of pneumonic atelectasis,there were no postoperative complications in the other cases.Conclusion Perioperative airway management in neonates with congenital atresia of esophagus,to improve the safety of neonatal surgery,reduce perioperative complications,promote early recovery of newborns after operation.