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在内镜逆行胆细胞造影过程中呼吸道管理的新趋势:叙述性综述
Federica Maiellare1, Fabio Sbaraglia1, Miryam Del Vicario1
1Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00136 Rome, Italy.
Journal of clinical medicine
|August 28, 2025
概括
目前的证据不支持单一的呼吸道管理策略. 麻醉师必须在ERCP期间平衡患者因素,程序复杂性和可用的资源,以实现最佳的呼吸道管理.
科学领域:
- 麻醉学
- 胃肠病学
- 内镜手术
背景情况:
- 透视逆向胆道瘤造影 (ERCP) 是胆道和胰腺疾病的关键诊断和治疗工具.
- 由于程序的复杂性和患者的并发症增加,ERCP的麻醉管理已经转向全身麻醉 (GA).
研究的目的:
- 审查目前ERCP的气道管理策略.
- 突出一个最好的方法缺乏明确的证据.
- 讨论影响呼吸道管理的因素.
主要方法:
- 对ERCP期间空气管道管理的现有文献进行叙述性审查.
- 检查自发呼吸,内管道输入,高流量鼻氧 (HFNO) 和上空气道装置 (SGA).
- 对患者特异性因素,程序复杂性和资源可用性的分析.
主要成果:
- 对于ERCP来说,没有一个单一的气道管理策略是绝对优越的.
- 自发呼吸与镇静适合低风险的程序, 但有吸气风险.
- 整体麻醉提供了更好的程序条件,但资源密集.
结论:
- 在ERCP期间的呼吸道管理需要灵活,以患者为中心的方法.
- 临床决策必须综合患者的风险,程序需求和可用的资源.
- 需要进一步的研究来制定基于证据的ERCP气道管理指南.
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