中国口腔医学继续教育杂志 ›› 2023, Vol. 26 ›› Issue (6): 479-483.DOI: 10.12337/zgkqjxjyzz.2023.06.005

• 病例报告 • 上一篇    下一篇

儿童声门下异物取出麻醉管理1例

白惠萍, 李建军*   

  1. 山东大学齐鲁医院(青岛)
  • 出版日期:2023-11-30 发布日期:2024-03-13
  • 通讯作者: *李建军,联系方式:0532-66850629,电子邮箱:ljj9573@163.com,通讯地址:山东省青岛市市北区合肥路758号,266035
  • 基金资助:
    青岛市重点专科资助(项目编号:QDZDZK2022094)

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

Huiping Bai, Jianjun Li*   

  1. Qilu Hospital of Shandong University (Qingdao), Qiangdao, Shandong Province, P.R. China
  • Online:2023-11-30 Published:2024-03-13
  • Contact: *Jianjun Li. Tel: 0532-66850629. Email: ljj9573@163.com. Address: No.758 Hefei Road, Shibei District, Qingdao 266035, Shandong Province, P.R. China.
  • Supported by:
    The Qingdao Key Health Discipline Development Fund (No. 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。

关键词: 声门下异物, 自主呼吸, 监护麻醉, 异物取出术, 癫痫

Abstract: 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.

Key words: subglottic foreign body, autonomous respiration, monitored anesthesia care, removal of foreign body, epilepsy