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维持气道通畅是口腔颌面创伤麻醉处理的重要课题。观察显示口腔颌面部外伤容易并发呼吸道梗阻,尤其是合并颅脑外伤者、昏迷状态、颌面部大出血、各种异物、舌根后坠等。相关报道合并颅脑外伤昏迷时,呼吸道问题引起的死亡,往往高于创伤本身。随着麻醉学技术的进步和对困难气道的深入认识以及麻醉药品器械的研制,解决问题的手段也日益增多。但每种解决办法都有自身特点,即适应证或禁忌证,尚需深入研究。颌面创伤气道的安全性关键在于围术期如何避免缺氧,有防范策略;其次是如何熟练应用各种插管方法。

Airway management under general anesthesia during operation for oral and maxillofacial injuries

Establishment and maintenance of fluent re-spiratory tract is important in management of general anesthe-sia in surgery for oral and maxillofacial injuries. Patients with oral and maxillofaeial injuries are likely to have obstruction of respiratory tract, especially patients with coma, massive hem-orrhage, foreign bodies in respiratory tract and wallowing tongue base. Studies showed that the mortality caused by re-spiratory problems is higher than that caused by injury itself in patients with oral and maxiUofacial injuries. Along with the in-novation of anesthesia, in-depth understanding of difficult re-spiratory tract and development of new anesthetic or instru-ment, more and more methods can be attained for management of the respiratory tract in surgery for oral and maxillofacial in-juries. The pivot of maintenance of fluent respiratory tract is taking effective steps to avoid lack of oxygen in pre-operation period. It is also important to use all kinds of intubation meth-ods and technologies skillfully.