经鼻高流量氧疗用于小儿喉气道手术自主呼吸麻醉的临床研究进展
Clinical Research Progress of High-Flow Nasal Cannula in Spontaneous Breathing Anesthesia for Pediatric Laryngeal Surgery
DOI: 10.12677/acm.2026.1641505, PDF,   
作者: 袁 锐, 徐 颖*：重庆医科大学附属儿童医院麻醉科，儿童少年健康与疾病国家临床医学研究中心，儿童发育疾病研究教育部重点实验室，重庆市卫生健康委儿童重要器官发育与疾病重点实验室，重庆
关键词: 小儿喉气道手术；经鼻高流量氧疗(HFNC)；自主呼吸麻醉；共享气道；围术期管理；Pediatric Laryngeal Airway Surgery； High-Flow Nasal Cannula (HFNC)； Spontaneous Breathing Anesthesia； Shared Airway； Perioperative Management
摘要: 小儿喉气道手术因患儿独特的解剖生理特征及“共享气道”的手术特殊性，围术期氧合与通气管理面临极高挑战。经鼻高流量氧疗(high-flow nasal cannula, HFNC)作为一种支持自主呼吸的新型非侵入性技术，凭借高流量输送、呼气末正压、死腔冲刷等机制，在提供稳定氧合的同时，允许患儿保留自主呼吸。相较于控制呼吸，HFNC避免了肌松药与机械通气的干扰，显著降低了气道黏膜损伤、喉痉挛等不良反应，且能优化术野暴露，提升围术期生理适配性，缩短术后恢复时间。目前，HFNC在小儿喉气道手术中的应用已从初步可行性验证，向参数个体化优化与多场景拓展方向深入，但临床应用中仍存在疗效异质性、特殊人群适配争议及安全风险管控等问题，且缺乏大样本多中心长期随访研究。本文系统综述HFNC的技术机制、在小儿喉气道手术中的应用优势、研究现状及现存挑战，为该技术在小儿喉气道手术麻醉中的个体化应用与优化提供科学参考。
Abstract: Pediatric laryngotracheal surgery presents major challenges for perioperative oxygenation and ventilation due to the unique anatomy and physiology of children and the shared airway condition. As a novel noninvasive technique for supporting spontaneous respiration, high-flow nasal cannula (HFNC) delivers stable oxygenation while allowing patients to maintain spontaneous breathing through mechanisms including high-flow delivery, positive end-expiratory pressure, and dead space flushing. Compared with conventional tracheal intubation, HFNC reduces airway complications, improves surgical exposure, and accelerates postoperative recovery. The application of HFNC has evolved from feasibility verification to individualized optimization and wider implementation. However, challenges remain, including heterogeneous efficacy, debates in special populations, and safety management. Large-scale, multicenter, long-term studies are still insufficient. This review summarizes the mechanisms, benefits, current status, and challenges of HFNC in pediatric laryngotracheal surgery, providing evidence for its individualized anesthetic application.
文章引用：袁锐, 徐颖. 经鼻高流量氧疗用于小儿喉气道手术自主呼吸麻醉的临床研究进展[J]. 临床医学进展, 2026, 16(4): 2540-2547. https://doi.org/10.12677/acm.2026.1641505

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