A case of difficult airway ( 一例困难气道）

shenxiu2

我们用的是土方法。
我们在术前就和病人讨论了气管切开的可能性，并且让他签了知情同意书。
诱导前，准备了喉罩。并且让他拿出了人造上颌。
我们在他的瘘管缺口上覆盖上了纱布和胶布。封了漏气的洞。然后吸入诱导。
麻醉深了，就用喉镜McCoy,看到咽喉声门后，就让另一人静脉注射肌松药司可林，接着插管。

We tried a simple method.
During preanesthetic visit , we discussed with the patient the possibility of the need of tracheostomy. And let him signed the consent for it.
Prior to induction , we got ready laryngeal mask . And we asked him to remove the Obturator.
We used gauze and plaster to cover the defect on the face. So that the leak is  much reduced. Then wen proceeded with inhalational induction.( Sevoflurane)

When the anesthesia is deep enough, we use McCoy laryngoscope to have a look , after visualization of the larynx and the vocal cords, another operator injected the muscle relaxant ( Scoline ) , and intubated him.

943860308

删掉这个图片吧，或隐藏一下 ，每次上论坛都被吓一跳！！！！！！！！！！！！！！！！！！！！！！！！！！！！

toutou

学习了，前辈真高呀，肯定下喉镜插管的时候也比较困难，牙也有缺损~~~

shenxiu2

回复 15# wemychy

这台手术的主刀医生是某国国家癌症中心的主任，头颈外科专家。在他的诊所里进出的很多病人都是这个模样，有些半张面孔都不见了。在还没有作重建手术之前，他们都得带着这种模样过日子。我和他们谈的时候，心里挺佩服他们与癌症奋斗到底的勇气和坚强。

尤其是图中这个病人，他的坦然，和对生命的信心，使我印象深刻佩服。
这些都是有尊严的人，样子不好看，可是有颗令人尊敬的心灵。

The surgeon for this operation was the chief of a  national cancer institute. Many of his patients that walk in and out of his clinic are having similar appearance as this patient. Before they undergo reconstructive surgery , they have to carry on with their lives with this types of faces. When I talked with them , I really saluted their courage and determination in fighting cancer.

The man in this picture especially impressed me with his accepting attitude , and his faith towards life .
These are people with dignity , they may look ugly, but they have respectable souls.

shenxiu2

回复 16# toutou
Surprisingly the laryngoscopy was rather easy , probably because of the ample space inside the mouth after the removal of the prosthesis/ obturator.

喉镜倒是挺容易的，可能是因为把人造上颌取出后，口腔内的空间变大，视野也很好了。

taizi7576186

保留自主呼吸 经右侧鼻孔 纤支镜引导下咋样？