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目的:探讨新生儿先天性食道闭锁及气管食管瘘的麻醉方法及呼吸管理。方法:术前准备充分,麻醉维持以吸入低浓度七氟醚为主,必要时追加罗库溴胺。结果:本组患儿均顺利完成手术,术中单肺通气,均出现SpO2下降,经调整呼吸参数,加用呼气末正压通气(PEEP)(2～4)cmH2O,严重者暂停手术操作,膨胀双肺,恢复双肺通气,待SpO2正常后继续手术,术中无一例死亡。结论:新生儿先天性食管闭锁合并气管食管瘘,在充分的术前准备,术中严密观察,加强管理,是可以安全渡过围术期的。
Objective: To investigate the anesthesia and respiratory management of neonatal congenital esophageal atresia and tracheoesophageal fistula. Methods: Preoperative preparation, anesthesia to maintain inhaled low concentrations of sevoflurane, if necessary, additional rocuronium. Results: All the patients in this group were successfully performed the surgery, single lung ventilation during surgery, SpO2 decreased, adjusted for respiratory parameters, plus positive end-expiratory pressure (PEEP) (2 ~ 4) cmH2O, severe surgery was suspended , Dilate the lungs, resuscitation of both lungs, until the SpO2 normal operation, no case of death during surgery. Conclusion: Neonatal congenital esophageal atresia combined with tracheoesophageal fistula, in the full preoperative preparation, intraoperative and strict observation, strengthen management, is safe to cross the perioperative period.