chospasm? ?常见于哮喘、慢性支气管炎、肺气肿、过敏性鼻炎。Р㈠喉痉挛(laryngospasm):?Laryngospasm is a reflex, prolonged closure of?the vocal cords in response to a trigger, usually ?airway stimulation during light anesthesia.? (呼吸道保护性反射→声门闭合反射过度亢进)Р诱发原因(aetioloty):?◆低O2血症(hypoxaemia)、高CO2血症(hypercapnia)、口咽部分泌物(secretions of oropharynx)与反流胃内容物(regurgitation of gastric contents)刺激咽喉部。?◆口咽通气道(oropharynx airway)、喉镜(larynxoscopy)、气管插管操作(tracheal intubation)。?◆浅麻醉下手术操作(surgery manipulation under light anesthesia):扩肛、剥离骨膜、牵拉肠系膜及胆囊等。Р处理(management):?轻度:吸气时喉鸣:去除局部刺激后可自行缓解.?中度:吸气、呼气都出现喉鸣音:需面罩加压给O2.?重度:声门紧闭,气道完全阻塞,粗针环甲膜穿刺吸? O2or iv 肌松药→加压吸O2 or 气管插管。? If laryngospasm persists and hypoxaemia ensues,? muscle relaxant relaxes the vocal cords and allows? manual ventilation and oxygenation.?预防(prevention):避免浅全麻下行气管插管或手术操作,防缺O2与CO2蓄积。
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