国际麻醉学与复苏杂志   2017, Issue (12): 5-5
    
全身麻醉下经内镜逆行胰胆管造影术中气道管理
朱康丽, 王东春, 刘宇, 武晓丽, 季怀禹, 丁丽楠, 李悦1()
1.哈尔滨医科大学附属第一医院
Airway management in endoscopic retrograde cholangio?蛳pancreatography under general anesthesia
 全文:
摘要:

背景 全身麻醉下经内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography, ERCP)中气道管理是十分重要的。尽管目前有多种通气方式可供选择,但麻醉医生对于适合方式的选择仍存在分歧。 目的 对目前ERCP术中应用的几种通气方式进行综述。 内容 在全身麻醉的ERCP术中,良好的通气是预防或缓解呼吸系统并发症的关键环节。可供选择的通气方式包括鼻导管、鼻咽通气道、内镜面罩、气管内插管、喉罩、喉胃管与Pennine牙垫等。其中,鼻咽通气道易于实施,且当血氧饱和度下降时能够及时调整,而气管内插管更适合于反流误吸风险高的患者。 趋向 全身麻醉下ERCP术中选择合适的通气方式之前,应充分考虑患者的健康状况,在获取基本信息后,还需要进一步的问诊以指导选择。

关键词: 气道管理; 通气方式; 麻醉,全身; 经内镜逆行胰胆管造影术
Abstract:

Background Airway management is critical in patients undergoing endoscopic retrograde cholangiopancreatography(ERCP) during general anesthesia. Although several procedures for airway management are currently available, the practitioners have not reached consensus in the choice of appropriate one. Objective To review several ventilation modalities during ERCP. Content Under general anesthesia, ventilation is an essential process to effectively prevent or relieve respiratory complications during the performance of ERCP. Ventilation can be achieved with nasal catheter, nasopharyngeal airway, endoscopic mask, endotracheal intubation, laryngeal mask airway, gastro?蛳laryngeal tube, and pennine mouth guard, etc. Among these methods, nasopharyngeal ventilation is easy to conduct, and is feasible to adjust when blood oxygen saturation drops, while intratracheal intubation is suitable especially for patients with high risk of regurgitation. Trend One should take the health conditions of patients into serious consideration before choosing an appropriate modality for ventilation during ERCP under general anesthesia. Further investigations are required to provide fundamental information to guide the choice.

Key words: Airway management; Ventilation modes; Anesthesia, general; Endoscopic retrograde cholangiopancreatog?蛳raphy