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在不寻常的气管狭窄期间的气道管理:临床可行性试验
Demet Altun1, Mert Canbaz1, Dilek Altun2
1Istanbul Faculty of Medicine, Department of Anesthesiology Istanbul University Istanbul Turkey.
Laryngoscope investigative otolaryngology
|October 30, 2023
概括
这项研究表明,在手术期间使用薄内管 (Tritube) 和流控通风 (FCV) 是可行的,用于管理COVID-19相关的小结节狭窄症. 这种方法为肺功能受损的患者提供了良好的外科视图和适当的通风.
科学领域:
- 麻醉学和重症监护医学
- 耳鼻喉科 - 头部和部手术
- 呼吸系统医学 呼吸系统医学
背景情况:
- 长时间的输内管是喉支气管狭窄症 (LTS) 的危险因素.
- 与COVID-19相关的LTS带来了独特的挑战,原因是阴位影响狭窄位置和肺炎损害的肺机械.
- 在这些复杂的病例中,有效的呼吸道管理对麻醉师和外科医生至关重要.
研究的目的:
- 评估使用一种新型薄型,袖口内管 (Tritube) 的可行性.
- 评估Tritube与流量控制通风 (FCV) 的组合,用于气道管理.
- 为了管理COVID-19相关的LTS患者进行喉手术.
主要方法:
- 一项前性观察性可行性试验包括20名COVID-19相关的LTS患者,需要进行内喉外科手术.
- 使用超薄内管Tritube和FCV进行了气道管理和通风.
- 评估了可行性,通风效率和手术暴露.
主要成果:
- 机械通风的中位持续时间为17天,所有患者均进行了预呼吸.
- 内镜诊断证实了18/20患者的后部小结节狭窄症.
- 外科医生报告说,他们对手术暴露的满意度很高 (9/10),血液动力学/呼吸系统变量保持在正常范围内.
结论:
- 与FCV一起使用Tritube可用于喉外科手术,这些手术适用于患有后部小结肠狭窄症的患者.
- 特里图布提供了一个有利的外科手术场.
- FCV确保充足的通风,特别是在肺机械受损的患者中.
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