悬雍垂腭咽成形术围术期的麻醉处理

[目的]探讨悬雍垂腭咽成形术(UPPP)围术期适宜的插管和麻醉方法。[方法]对40例行UPPP病人围术期采用不同的插管方法，其中16例采用静脉快诱导经鼻明视气管内插管，12例术前行预防性气管切开，12例采用清醒镇静表麻下经鼻盲探气管内插管．比较插管时情况。其中非静脉诱导插管24例病人根据插管前是否泵入异舒吉分为异舒吉组和对照组，观察插管前后血压变化。[结果]经鼻明视气管内插管4例插管不顺利，2例插管期间SPO2下降明显；清醒镇静表麻下经鼻盲探气管内插管成功率100％，插管期间SPO2无明显变化，4例插管后无呛咳反应。插管前后异舒吉组血压无明显变化，对照组插管后血压明显升高。[结论]清醒镇静表麻下经鼻盲探气管内插管为UPPP首选；合适的麻醉深度加血管活性药物可维持稳定的血流动力学状态。

Anesthetic Management During Uvulopalatopharyngoplasty

ObjectiveTo explore the intubation method and anesthetic management during uvulopalatopharyngoplasty(UPP).Of 40 cases of uvulopalatopharyngoplasty ,16 cases underwent visible transnasal endotracheal intubation with intravenous anesthesia, 12 cases underwent tracheotomy ,and 12 cases underwent blind transnasal endotracheal intubation under local anesthesia and sedation. To observe the change of blood pressure at intubation time, 24 cases who did not receive intravenous anesthesia were allocated to group yishuji and group control . Four cases with intravenous anesthesia were not smoothly intubated , SPO 2 were decreased dramatically in 2 cases. The success rate of conscious intubation was 100%, SPO 2 remained normal,no cough after intubation in 4 cases. After intubation blood pressure showed no change in group yishuji, but in group control blood pressure was higher than that before intubation.[Conclusions]Blind transnasal conscious endotracheal intubation with sedation is the first choice for UPPP; appropriate anesthesia depth combined with yishuji can keep a stable hemodynamic state during perioperative period.