摘要
一例62岁男性患者在喷射通气下行直接显微喉镜检查和声带脂肪移植。长时间喉镜检查后，患者因为创伤性会厌炎出现过度通气和上呼吸道梗阻。放置喉罩后可进行通气，并可直视下观察患者会厌炎症，且不损伤脂肪移植物。因为喉罩放置在声带上方并能保证有效通气，所以我们认为，直接显微喉镜检查后，患者苏醒期间可能出现通气困难，而气管内插管可能会影响手术操作，宜选择间断性喉罩通气替代气管内插管作为一种有效的过渡性通气方式。
A 62-yr-old man presented for a microdirect laryngoscopy and vocal cord fat grafting under jet ventilation. After a prolonged laryngoscopy, the patient developed hypercapnea and upper airway obstruction secondary to traumatic epiglottitis. The placement of a laryngeal mask airway provided ventilation and allowed for direct visualization of the patient＇s inflamed epiglottis without disruption of the patient＇s fat graft. Because of its placement above the cords and its effectiveness in providing adequate ventilation, we propose intermittent laryngeal mask airway ventilation as a bridge, in lieu of endotracheal intubafion, in microdirect laryngoscopy cases in which ventilation during emergence may be difficult and the insertion of an endotracheal tube would disrupt the surgical procedure.
出处
《麻醉与镇痛》
2009年第2期39-41,共3页
Anesthesia & Analgesia
