基础医学与临床 ›› 2016, Vol. 36 ›› Issue (6): 822-825.

• 研究论文 • 上一篇    下一篇

强直性脊柱炎患者气道管理分析

马璐璐1,虞雪融1,黄宇光2   

  1. 1. 北京协和医院麻醉科
    2. 北京协和医院
  • 收稿日期:2015-11-26 修回日期:2016-02-29 出版日期:2016-06-05 发布日期:2016-05-27
  • 通讯作者: 黄宇光 E-mail:garybeijing@163.com

Analysis of airway management in patients with ankylosing spondylitis

  • Received:2015-11-26 Revised:2016-02-29 Online:2016-06-05 Published:2016-05-27

摘要: 目的 分析强直性脊柱炎患者的气道管理。 方法 对2004年1月-2014年12月在北京协和医院因强直性脊柱炎行骨科手术的171名患者的气道管理资料进行回顾性分析。 结果 96.5%患者选择全麻手术。 Macintosh喉镜和Glidescope喉镜声门暴露Cromack分级III-IV级分别占9.6%和6.6%。90.9%的患者首次插管成功。9例患者需要更换插管工具,并有2例出现困难通气。5例患者选择椎管内麻醉,其中1例因效果不佳而改为全身麻醉。结论 强直性脊柱炎患者由于脊柱和关节受累,属于困难气道高危,术前应充分评估和准备,选择最佳麻醉方案,减少并发症的发生。

关键词: 强直性脊柱炎, 气道管理, 困难气道

Abstract: Objective To evaluate the airway management among patients with ankylosing spondylitis. Method 171 patients who had orthopedic operations due to ankylosing spondylitis from January 2004 to December 2014 were enrolled. Result 96.5% of patients were operated under general anesthesia. The percentage of Cromack grade III and IV using Macintosh laryngoscopy and Glidescope were 9.6% and 6.6%, respectively. 90.6% patients were successfully intubated with first attempt. 9 patients had to change intubation devices and 2 had difficult mask ventilation. 5 patients received epidural and or spinal anesthesia and one of them had to change to general anesthesia because of incomplete block. Conclusion Patients with ankylosing spondylitis are at high risk of difficult airway due to the rigidity of spine and joints. Comprehensive preoperative evaluation and preparation, detailed anesthetic plan and decreasing complications are important for this specific group of patients.

Key words: ankylosing spondylitis, airway management, difficult airway

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