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[儿童胸外科手术中的插管与通气]

[Intubation and ventilation during thoracic surgery in children].

作者信息

Scherer Ralf

机构信息

Klinik für Anästhesiologie und operative Intensivmedizin am Clemenshospital, Münster.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2006 Oct;41(10):660-4. doi: 10.1055/s-2006-955862.

Abstract

Single lung ventilation is indicated in many cases for thoracic surgery in children. The indication for single lung ventilation and the airway management should always be discussed thoroughly with the surgeon in order to tailor the effort, complexity and risk of airway management to the needs of the patient. According to the height and age of the child endobronchial intubation, bronchial blockers, the Univent-tube and double lumen tubes can be used. During single lung ventilation infants are particularly predisposed to hypoxemia, because unlike adults in the lateral decubitus position the dependent ventilated lung is prone to alveolar collapse and does not receive a larger part of pulmonary perfusion than the non ventilated lung.

摘要

单肺通气在儿童胸外科手术的许多情况下都有应用指征。应始终与外科医生充分讨论单肺通气的指征和气道管理,以便根据患者需求调整气道管理的工作量、复杂性和风险。根据儿童的身高和年龄,可使用支气管内插管、支气管封堵器、单腔支气管导管和双腔导管。在单肺通气期间,婴儿特别容易发生低氧血症,因为与处于侧卧位的成人不同,下垂侧通气的肺容易发生肺泡萎陷,且与未通气的肺相比,接受的肺灌注量并不更多。

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