Welfringer P, Taron F, Bertrand D, Simon C, Wayoff M
Département d'Anesthésie-Réanimation, Hôpital Central, Nancy.
Cah Anesthesiol. 1988 Jan-Feb;36(1):17-22.
Resections and end-to-end anastomosis have been effective in correcting localized tracheal strictures. Important clinical considerations are the precise preoperative assessment of the lesion, careful planning of anesthetic management and choice of the appropriate decision. Surgical procedures involving sharing of the air way between the anaesthetist and the surgeon impose special problems on the anaesthetist. On the one hand, the surgeon requires unrestricted access to the operating site and on the other, the anaesthetist must ensure adequate anaesthesia, oxygenation and carbon dioxide elimination, preferably without contamination of the lung fields. The more commonly employed technique is the use of a tracheal tube so that anaesthesia can be maintained using conventional IPPV. In our experience, the majority of strictures in adults can be managed as well, or better, by using a conventional endotracheal tube.
切除及端端吻合术已有效地矫正了局限性气管狭窄。重要的临床考量包括对病变进行精确的术前评估、精心规划麻醉管理以及做出恰当的决策。涉及麻醉师与外科医生共享气道的外科手术给麻醉师带来了特殊问题。一方面，外科医生需要不受限制地进入手术部位，另一方面，麻醉师必须确保充分的麻醉、氧合及二氧化碳排出，最好不污染肺野。更常用的技术是使用气管导管，以便能通过传统的间歇正压通气维持麻醉。根据我们的经验，使用传统气管内导管也能很好地处理大多数成人狭窄，甚至效果更佳。
