麻醉师-复苏员在实践中的插管困难(综述文章)

Valentina V. Meshcheryakova
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引用次数: 0

摘要

自麻醉开始以来,气道困难一直是最严重的问题之一。由于无法维持气道通畅而导致的患者残疾和死亡,尽管近年来已显著减少,但仍然是麻醉和复苏领域的一个严重问题。临床病例插管失败或困难总是直接威胁到病人的生命,无论是在紧急情况下和计划的手术干预。本研究的目的:考虑危重患者气道管理的主要组成部分,以及生理复杂气道的更微妙的细节。研究材料:国外和俄罗斯文献资料中关于这一问题的资料。采用柠檬量表预测插管困难程度。结论。紧急情况下插管困难应基于严格的操作算法,以帮助麻醉师和复苏人员防止严重错误和不成功的操作,在增加患者缺氧的情况下。对于年轻的专业人员和有经验的医生来说,认识到这个问题并研究解决这个问题的方法是必要的;这将减少因困难和并发症而导致插管失败的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intubation difficulties in practice of an anesthesiologist-resuscitator (review article)
Difficult airways have been one of the most serious problems in anesthesia since its inception. Disability and mortality of patients due to the inability to maintain airway patency remains a serious problem in anesthesiology and resuscitation although they have significantly decreased in recent years. Clinical cases of unsuccessful or difficult intubations are always a direct threat to the patient’s life both in emergency situations and during planned surgical intervention. The purpose of the research: to consider the main components of airway management in critically ill patients, as well as more subtle details of physiologically complex airways. Materials of the research: foreign and Russian literary sources on the problem. To assess the difficulty of intubation, the prediction on the LEMON scale was used. Conclusion. Difficult intubation in emergency conditions should be based on a strict algorithm of actions that helps anesthesiologists and resuscitators to prevent gross mistakes and unsuccessful manipulations in conditions of increasing patient’s hypoxia. Awareness of this issue and the research of ways to resolve it are necessary for both young professionals and experienced doctors; that will reduce the risks of unsuccessful intubation with the development of difficulties and complications.
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