氟骨症性颈椎管狭窄症手术的麻醉管理  

Anesthetic Management for Fluorosis Cervical Stenosis Operations

作　　者：刘伟平[1] 韩永正[1] 张耕[1] 张梁[1] 王军[1] 郭向阳[1] 

机构地区：[1]北京大学第三医院麻醉科,北京100191

出　　处：《中国微创外科杂志》2014年第8期744-746,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：2009年北京大学第三医院临床重点项目(63531-01);2012年卫生计生委麻醉学临床重点专科建设项目

摘　　要：目的探讨氟骨症性颈椎管狭窄症手术的麻醉特点及管理方法。方法对2009年2月～2014年3月5例氟骨症性颈椎管狭窄症的麻醉管理进行总结。2例术前颈椎活动严重受限，改良Mallampati分级Ⅲ级，考虑可能为困难气管插管，清醒表面麻醉下行纤维支气管镜引导气管插管；余3例为非困难气管插管，行快速诱导直视下Macintosh喉镜气管插管。结果5例均安全度过围术期，无死亡。1例因呼吸功能不全，术后转入ICU病房，次日拔管；余4例术后转入PACU拔管。术后均无麻醉相关并发症，顺利出院。结论氟骨症性颈椎管狭窄症患者困难气道发生率高，气道管理是围术期麻醉管理的核心问题。Objective To explore the anesthetic management during operation for fluorosis cervical stenosis. Methods The demographic data, surgical parameters, and anesthetic management of 5 patients with fluorosis cervical stenosis from February 2009 to March 2014 were analyzed. Two of the 5 patients had severely limited movement of cervical spine and were classified as Mallampati grade Ⅲ. Both of them received awake fiberoptic intubation under topical anesthesia. The remaining three patients had no difficulty in tracheal intubation and were intubated with Macintosh direct laryngoscope under rapid anesthesia induction. Results All the patients underwent the surgery smoothly, without deaths during the perioperative period. After surgery, 1 patient was transferred to the ICU due to respiratory insufficiency and was extubated on the following day. The remaining 4 patients were transferred to the PACU and had the tracheal tube removed there afterwards. All the patients had no anesthesia related complications after operation and were discharged uneventfully. Conclusions Patients with fluorosis cervical stenosis have a high incidence of difficult airway. Airway management is the key of perioperative anesthetic management.

关 键 词：氟骨症性颈椎管狭窄症 麻醉管理 困难气道 

分 类 号：R614.2[医药卫生—麻醉学]