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困难气道的原因。

Causes of the difficult airway.

作者信息

Orfanos John G, Quereshy Faisal A

机构信息

Department of Oral & Maxillofacial Surgery, Case School of Dental Medicine, University Hospitals Case Medical Center Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH 44106, USA.

出版信息

Atlas Oral Maxillofac Surg Clin North Am. 2010 Mar;18(1):1-9. doi: 10.1016/j.cxom.2009.11.001.

Abstract

Recognizing a potentially difficult airway is important in avoiding a life-threatening emergency. There are 2 separate scenarios for considering the difficult airway: difficult mask ventilation (DMV) and difficult tracheal intubation (DTI). DMV can be described as lacking the ability to maintain oxygen saturation or lacking the ability to reverse signs of inadequate ventilation with positive-pressure mask ventilation under general anesthesia. DTI remains constant among anesthesia-related patient injuries, and is the third most common respiratory-related episode leading to death and possible brain damage. It is important to preoperatively assess every patient by completing a full history and physical. A thorough history can provide clues in detecting a possible difficult airway. Airway impairment has been further subdivided into the anatomic regions that affect the airway, namely above the larynx, supraglottic, glottic, subglottic, and tracheobronchial. This article discusses the factors that can result in a difficult airway.

摘要

识别潜在的困难气道对于避免危及生命的紧急情况很重要。考虑困难气道有两种不同的情况:困难面罩通气(DMV)和困难气管插管(DTI)。DMV可描述为在全身麻醉下缺乏维持氧饱和度的能力或缺乏通过正压面罩通气纠正通气不足体征的能力。DTI在与麻醉相关的患者损伤中一直存在,并且是导致死亡和可能脑损伤的第三大常见呼吸相关事件。术前通过完成全面的病史采集和体格检查对每位患者进行评估很重要。详尽的病史可以为检测可能的困难气道提供线索。气道损伤已进一步细分为影响气道的解剖区域,即喉上、声门上、声门、声门下和气管支气管。本文讨论了可能导致困难气道的因素。

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