儿童声门下异物取出麻醉管理1例  

Monitored Anesthesia Care Management for Removal of Subglottic Foreign Body in Children

作　　者：白惠萍 李建军 Huiping Bai;Jianjun Li(Qilu Hospital of Shandong University(Qingdao),Qiangdao,Shandong Province,P.R.China)

机构地区：[1]山东大学齐鲁医院(青岛)

出　　处：《中国口腔医学继续教育杂志》2023年第6期479-483,共5页Chinese Journal of Stomatologial Continuing Education

基　　金：青岛市重点专科资助(项目编号:QDZDZK2022094)。

摘　　要：目的:探讨儿童声门下异物取出术保留自主呼吸的监护麻醉(monitored anesthesia care,MAC)管理要点。诊治经过:术前电子喉镜检查明确异物位于声门下,采用保留自主呼吸的MAC麻醉方法,而非传统的全身麻醉,于喉镜直视下行异物取出术。结果:麻醉过程无呼吸抑制,异物取出顺利,患儿恢复良好,术后2天顺利出院。结论:对于明确诊断的声门下异物,在麻醉前严格评估,制定备选麻醉方案,术中术后严密监护的条件下,保留自主呼吸的MAC麻醉方法可满足儿童于喉镜直视下行异物取出术的麻醉效果。Objective:This study explores the key management points of monitored anesthesia care(MAC)for the removal of subglottic foreign body in children,while preserving autonomous respiration.Diagnosis and treatment:Preoperative electronic laryngoscopy was performed to confirm the presence of foreign body below the glottis.The MAC anesthesia method,which preserves autonomous respiration instead of traditional general anesthesia,was adopted for the removal procedure under direct laryngoscopic visualization.Results:The anesthesia procedure did not cause respiratory depression,and the foreign bodies were successfully removed.The patient recovered well and was discharged after two days of surgery.Conclusions:For diagnosed subglottic foreign body,strict pre-anesthetic assessment,establishment of alternative anesthesia plans,and close monitoring during and after the procedure support the efficacy of MAC anesthesia,which preserves autonomous respiration,in children undergoing foreign body removal under direct laryngoscopic visualization.

关 键 词：声门下异物 自主呼吸 监护麻醉 异物取出术 癫痫 

分 类 号：R61[医药卫生—外科学]