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儿科麻醉和阿喀拉西亚:在口腔内镜骨髓瘤管理方面拥有10年的经验
Fabio Sbaraglia1, Pietro Familiari2, Federica Maiellare3
1Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario "A Gemelli" IRCCS, Roma, Italy. fabiosbaraglia@hotmail.com.
Journal of anesthesia, analgesia and critical care
|June 29, 2023
概括
门口内镜肌切除术 (POEM) 对于儿科阿喀拉西亚具有较低的风险,但需要谨慎的气道管理和通风策略. 麻醉科医生必须在这个内镜手术过程中应对CO2灌气和潜在的通风困难等挑战.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 最少侵入性的手术
- 麻醉学 麻醉学
背景情况:
- 口腔内镜肌切除术 (POEM) 是一种新的内镜治疗 achalasia,自2012年以来适应儿科使用.
- 儿科阿喀拉西亚很罕见,儿童POEM的麻醉治疗尚未得到充分记录.
- 这项研究解决了儿科POEM期间呼吸道管理和机械通风的临床挑战.
研究的目的:
- 评估在接受POEM的儿科患者的麻醉管理和相关风险.
- 在这一群体中确定与输管和机械通风相关的具体挑战.
- 评估POEM在患有秋症的儿童中的安全性.
主要方法:
- 在2012年至2021年期间接受POEM的31名儿科患者 (3-18岁) 的回顾性分析.
- 收集的数据包括人口统计,麻醉技术,呼吸道管理,通风和不良事件.
- 专注于快速序列诱导,二氧化碳吸入效应和通风策略.
主要成果:
- 31名患有阿喀拉西亚的儿科患者接受了POEM.
- 在30名患者中使用了快速序列诱导,有效地预防了吸入性肺炎.
- 所有患者都经历了CO2灌气的影响,通常需要调整通风;没有发生危及生命的事件.
结论:
- 对于儿科阿喀拉西亚的POEM似乎具有低风险概况,并采取适当的预防措施.
- 吸入风险是通过快速序列诱导减轻,尽管在一些患者的全食道状态.
- 在道化阶段,机械通风可能具有挑战性,需要进一步研究最佳策略.
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