Page 31 - CASA Bulletin of Anesthesiology 2022; 9(2) (5)
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Vol. 9, No 2, 2022
图 4：FuJi 钢丝增强单腔管 WRETT （ambuusa.com）
总结
困难气道术中管理的首要目标是建立气道。困难气道同时需要单肺通气传统上最安全的方法
是经鼻或者经口清醒插管，然后再使用阻塞导管实现肺隔离 4,32 。随着各种可视技术的发展和新设
备的出现，很多时候双腔管可以在全麻诱导后经可视喉镜或合并纤维支气管镜的帮助下安全地放
置，或者诱导后通过单腔管合并阻塞导管或者置换为双腔管来实现肺隔离。对于气管切开术后的
病人，可以通过气切套管放置阻塞导管。在无法通气和无法插管的极端情况下，除去建立有创气
道外还可以考虑使用 ECMO。
参考文献
1. Apfelbaum JL, Hagberg CA, Connis RT, Abdelmalak BB, Agarkar M, Dutton RP, Fiadjoe JE, Greif R, Klock PA, Mercier D,
Myatra SN, O’Sullivan EP, Rosenblatt WH, Sorbello M, Tung A: 2022 American Society of Anesthesiologists Practice
Guidelines for Management of the Difficult Airway. Anesthesiology 2022; 136:31–81
2. 于布为 吴新民 左明章 邓晓明 高学 田鸣: 困难气道管理指南. 临床麻醉学杂志 2013; 29:93–8
3. Grimes D, MacLeod I, Taylor T, O’Connor M, Sidebottom A: Computed tomography as an aid to planning intubation in the
difficult airway. The British journal of oral & maxillofacial surgery 2016; 54:80–2
4. Globokar MD, Novak-Jankovic V: Difficult airway and one lung ventilation. Acta clinica Croatica 2012; 51:477–82
5. Collins SR, Titus BJ, Campos JH, Blank RS: Lung Isolation in the Patient With a Difficult Airway. Anesthesia and analgesia
2018; 126:1968–78
6. Brodsky JB, Lemmens HJM: Left double-lumen tubes: clinical experience with 1,170 patients. Journal of cardiothoracic and
vascular anesthesia 2003; 17:289–98
7. Mittal AK, Kulkarni A: A simple method to protect tracheal cuff of double lumen tube from damage during intubation. Journal
of anaesthesiology, clinical pharmacology 2012; 28:417–8
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