前路颈椎术后咽喉及椎前软组织水肿致气道损伤研究进展  

Research Progress of Airway Compromise Due to Edema of the Laryngopharynx and Prevertebral Soft Tissues after Anterior Cervical Spine Surgery

作　　者：戴建强[1] 陈坤[1] 蔡学究[1] 张亮达[1] 黄显华[1] 尹庆水[1] DAI Jianqiang;CHEN Kun;CAI Xuejiu;ZHANG Liangda;HUANG Xianhua;YIN Qingshui(Orthopedic Hospital,Guangzhou General Hospital of Guangzhou Military Command,Guangzhou 510010,China)

机构地区：[1]广州军区广州总医院骨科医院,广州510010

出　　处：《医学综述》2018年第15期3029-3033,3038,共6页Medical Recapitulate

摘　　要：前路颈椎术后常因咽喉及椎前软组织水肿导致气道损伤,当患者出现严重气道梗阻时需要紧急气管插管,而对于带管患者何时方可安全拔管存在争议。为有效应对此类气道损伤,需要熟知相关解剖知识、风险因素、诊断及防治措施。依据是否存在主要(即手术)风险因素可将患者分为低、中、高风险类别,并通过改善麻醉策略、优化手术操作、拟制特定术后气道保护方案等措施,可以降低术后气道损伤的发生率,并达到安全拔管的目的。Airway compromise after cervical spine surgery is the most commonly produced by edema of the laryngopharynx and prevertebral soft tissues. Urgent tracheal intubation is often required when a patient has severe airway obstruction,and for patients with a tube,it is difficult to decide when the tube can be removed safely. Effective management of airway compromise after cervical spine surgery requires an understanding of the anatomy,risk factors,diagnosis and prevention measures. The number of primary（ surgical） risk factors allows for stratification of patients into low,intermediate,or high-risk categories. By improving anesthesia strategies,optimizing surgical procedures,and formulating specific postoperative airway protection programs,it is possible to reduce the incidence of postoperative airway compromise and to achieve the goal of safe extubation.

关 键 词：前路颈椎手术 咽喉水肿 椎前软组织水肿 术后气道损伤 气道保护方案 

分 类 号：R619[医药卫生—外科学]