关键词: 围手术期气道管理, 先天性气管狭窄, 应用效果, 儿童

Abstract:

Objective To summarize the effect of perioperative airway management program in congenital long-segment tracheal stenosis. Methods Children undergone tracheal slide angioplasty in the Department of Thoracic Surgery at Shanghai Children's Medical Center were selected as the study group. Eighty-five children following conventional perioperative management protocol from January 2015 to December 2017 were selected as the control group, and 173 children from January 2018 to December 2020 were selected as the intervention group, and the airway management protocol was added to the conventional perioperative management. Results A total of 258 children with congenital long-segment tracheal stenosis were recruited. The median age was 12.0 (9.0-17.0) months and the median body mass was 8.6 (7.0-10.6) kg. The preoperative age and body mass of the intervention group were lower than those of the control group, and the difference was statistically significant (all P<0.05). The intubation time in the intervention group was shorter than that in the control group, and the reintubation rate and positive alveolar lavage fluid culture rate were lower than those in the control group, with statistically significant differences (all P<0.05). The results of fiberoptic bronchoscopy before extubation showed that the postoperative complication rates of mucosal invagination, airway inflammation, anastomotic mucosal bleeding erosion, small amount of airway bleeding and sputum plug obstruction were lower in the intervention group than those in the control group, with statistically significant differences (P<0.05). Conclusion A multidisciplinary perioperative airway management program is effective in children with congenital tracheal stenosis and can reduce a variety of postoperative airway complications as well as reduce the duration of mechanical ventilation and facilitate the recovery ofthe child.

Key words: perioperative airway management, congenital tracheal stenosis, application effect, child