中国实用口腔科杂志
中國實用口腔科雜誌
중국실용구강과잡지
CHINESE JOURNAL OF PRACTICAL STOMATOLOGY
2009年
6期
339-341
,共3页
颌面部创伤%气道管理%麻醉%气管插管
頜麵部創傷%氣道管理%痳醉%氣管插管
합면부창상%기도관리%마취%기관삽관
maxillofacial injury%airway management%an-esthesia%tracheal intubation
维持气道通畅是口腔颌面创伤麻醉处理的重要课题.观察显示口腔颌面部外伤容易并发呼吸道梗阻,尤其是合并颅脑外伤者、昏迷状态、颌面部大出血、各种异物、舌根后坠等.相关报道合并颅脑外伤昏迷时,呼吸道问题引起的死亡,往往高于创伤本身.随着麻醉学技术的进步和对困难气道的深入认识以及麻醉药品器械的研制,解决问题的手段也日益增多.但每种解决办法都有自身特点,即适应证或禁忌证,尚需深入研究.颌面创伤气道的安全性关键在于围术期如何避免缺氧,有防范策略;其次是如何熟练应用各种插管方法.
維持氣道通暢是口腔頜麵創傷痳醉處理的重要課題.觀察顯示口腔頜麵部外傷容易併髮呼吸道梗阻,尤其是閤併顱腦外傷者、昏迷狀態、頜麵部大齣血、各種異物、舌根後墜等.相關報道閤併顱腦外傷昏迷時,呼吸道問題引起的死亡,往往高于創傷本身.隨著痳醉學技術的進步和對睏難氣道的深入認識以及痳醉藥品器械的研製,解決問題的手段也日益增多.但每種解決辦法都有自身特點,即適應證或禁忌證,尚需深入研究.頜麵創傷氣道的安全性關鍵在于圍術期如何避免缺氧,有防範策略;其次是如何熟練應用各種插管方法.
유지기도통창시구강합면창상마취처리적중요과제.관찰현시구강합면부외상용역병발호흡도경조,우기시합병로뇌외상자、혼미상태、합면부대출혈、각충이물、설근후추등.상관보도합병로뇌외상혼미시,호흡도문제인기적사망,왕왕고우창상본신.수착마취학기술적진보화대곤난기도적심입인식이급마취약품기계적연제,해결문제적수단야일익증다.단매충해결판법도유자신특점,즉괄응증혹금기증,상수심입연구.합면창상기도적안전성관건재우위술기여하피면결양,유방범책략;기차시여하숙련응용각충삽관방법.
Establishment and maintenance of fluent re-spiratory tract is important in management of general anesthe-sia in surgery for oral and maxillofacial injuries. Patients with oral and maxillofaeial injuries are likely to have obstruction of respiratory tract, especially patients with coma, massive hem-orrhage, foreign bodies in respiratory tract and wallowing tongue base. Studies showed that the mortality caused by re-spiratory problems is higher than that caused by injury itself in patients with oral and maxiUofacial injuries. Along with the in-novation of anesthesia, in-depth understanding of difficult re-spiratory tract and development of new anesthetic or instru-ment, more and more methods can be attained for management of the respiratory tract in surgery for oral and maxillofacial in-juries. The pivot of maintenance of fluent respiratory tract is taking effective steps to avoid lack of oxygen in pre-operation period. It is also important to use all kinds of intubation meth-ods and technologies skillfully.