本文選題：氣管內(nèi)麻醉 + 氣道病變�。� 參考：《山東大學(xué)》2014年碩士論文

【摘要】：目的探討氣管病變患者氣管內(nèi)麻醉的常見(jiàn)和罕見(jiàn)問(wèn)題,并提出對(duì)策；討論可視技術(shù)在氣管病變麻醉的意義及注意事項(xiàng)。 方法山東大學(xué)第二醫(yī)院2013年1月到12月的氣管病變需要?dú)夤軆?nèi)麻醉患者15例,其中氣管支架后需要?dú)夤懿骞艿幕颊?例,瘢痕性氣管狹窄患者2例,氣管內(nèi)腫瘤5例,氣管外傷2例。清醒氣管插管3例,快速誘導(dǎo)氣管插管10例,氣管切開(kāi)2例。所有患者都在可視喉鏡引導(dǎo)下,把套有氣管插管的纖支鏡插入氣管,氣管插管進(jìn)入聲門(mén)。在纖支鏡引導(dǎo)下13例完成氣管插管,1例氣管狹窄患者氣管切開(kāi),1例氣管斷裂患者改由快速氣管切開(kāi)插管成功。 結(jié)果13例患者順利完成氣管內(nèi)插管麻醉,其中1例氣管斷裂患者發(fā)生纖支鏡引導(dǎo)下氣管插管困難,快速氣管切開(kāi)插管成功,1例氣管狹窄患者氣管切開(kāi)。2例氣管支架后需要?dú)夤懿骞艿幕颊?拔管時(shí)發(fā)生氣管支架移位,需要在纖支鏡引導(dǎo)下重新調(diào)整氣管支架位置。 結(jié)論術(shù)前認(rèn)真訪(fǎng)視病人,針對(duì)性制定個(gè)性化麻醉方案,熟練應(yīng)用纖維支氣管鏡和可視喉鏡技術(shù),是氣管病變的氣管內(nèi)麻醉成功的關(guān)鍵。
[Abstract]:Objective to discuss the common and rare problems of trachea anesthesia in patients with tracheal diseases, and to discuss the significance of visual technique in trachea anesthesia. Methods from January to December 2013, 15 patients with trachea diseases needed endotracheal anesthesia, including 6 patients with tracheal stents, 2 patients with scar tracheal stenosis and 5 patients with intratracheal tumors. There were 2 cases of trachea trauma. Conscious tracheal intubation in 3 cases, rapid induction of endotracheal intubation in 10 cases, tracheotomy in 2 cases. All patients were guided by visual laryngoscope to insert a fiberoptic bronchoscope with tracheal intubation into the glottis. Under the guidance of fiberoptic bronchoscope, 13 patients with trachea intubation and 1 patient with trachea stenosis underwent tracheotomy. One patient with trachea rupture was successfully intubated by rapid tracheotomy. Results 13 patients successfully completed endotracheal intubation anesthesia, and one patient with tracheal rupture suffered from tracheal intubation difficulties under fiberoptic bronchoscopy. Rapid tracheotomy and intubation was successful in 1 patient with trachea stenosis. After tracheotomy, 2 patients needed tracheal stent intubation. Tracheal stent displacement occurred during extubation, and the tracheal stent position should be readjusted under the guidance of fiberoptic bronchoscope. Conclusion the key to success of tracheal anesthesia is to visit patients carefully before operation, to draw up individualized anaesthesia plan and to apply fiberoptic bronchoscopy and visual laryngoscope skillfully.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R614

【參考文獻(xiàn)】

相關(guān)期刊論文 前8條

1 鐘河江;種朋貴;楊天德;陶軍;;氣管支氣管成形術(shù)的圍術(shù)期麻醉管理[J];重慶醫(yī)學(xué);2008年17期

2 邱小明;陳軍;周清華;;原發(fā)性氣管腫瘤的診斷與治療進(jìn)展[J];中國(guó)肺癌雜志;2011年01期

3 亓放,張連山;原發(fā)性氣管腫瘤[J];國(guó)外醫(yī)學(xué)(耳鼻咽喉科學(xué)分冊(cè));2004年01期

4 吳榮信,丁雄,吉儉,鄭忠欣,黎南中,陳衛(wèi)東;不同單肺通氣模式與動(dòng)脈血氧分壓關(guān)系的實(shí)驗(yàn)與臨床研究[J];華南國(guó)防醫(yī)學(xué)雜志;2000年02期

5 朱士啟;張亮;趙鵬程;;CT對(duì)原發(fā)性氣管腫瘤診斷的價(jià)值[J];中國(guó)醫(yī)藥指南;2009年22期

6 ;Case Reports:Anesthetic management of emergent critical tracheal stenosis[J];Journal of Zhejiang University(Science B:An International Biomedicine & Biotechnology Journal);2007年07期

7 許建,高天華;氣管腫瘤切除與氣道重建手術(shù)麻醉處理[J];中華麻醉學(xué)雜志;1999年07期

8 徐莉,郭曲練,鄢建勤,王云嬌,陳勝喜;氣管下段腫瘤切除術(shù)的麻醉處理[J];中華麻醉學(xué)雜志;2001年09期

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