Starship Hospital, Auckland, New Zealand.
Best Pract Res Clin Anaesthesiol. 2010 Sep;24(3):387-401. doi: 10.1016/j.bpa.2010.02.010.
Tracheo-oesophageal fistula (TOF) and oesophageal atresia (OA) represent a series of anatomical abnormalities presenting for emergency surgery in the neonatal period. They present the anaesthetist with cardio-respiratory challenges in the preoperative, intra-operative and postoperative phases. In addition to the consequences of the pathology itself, co-morbidities are very common, which superimpose further considerations. The basic science, anatomy and genetics are discussed as well as the clinical presentation, perioperative management, controversies and complications. The evidence for optimum management is based mostly on expert opinion; there are very few large randomised controlled trials concerning many areas of perioperative management.
气管食管瘘(TOF)和食管闭锁(OA)代表了一系列在新生儿期进行紧急手术的解剖异常。它们在术前、术中及术后阶段给麻醉师带来了心肺挑战。除了病理本身的后果外,还常伴有合并症,这进一步增加了考虑因素。本文讨论了基础科学、解剖学和遗传学,以及临床表现、围手术期管理、争议和并发症。最佳管理的证据主要基于专家意见;关于许多围手术期管理领域,很少有大型随机对照试验。