无痛消化内镜麻醉气道管理的研究现状与进展
Current Status and Progress in Airway Management for Painless Digestive Endoscopy Anesthesia
DOI: 10.12677/acm.2026.1652071, PDF,   
作者: 朱 叶*：山东医药大学第一临床医学院，山东 滨州；山东第一医科大学第一附属医院(山东省千佛山医院)麻醉科、山东省麻醉与呼吸重症研究所、山东省麻醉医学临床医学研究中心，山东 济南；尤 琦*, 吴剑波#：山东第一医科大学第一附属医院(山东省千佛山医院)麻醉科、山东省麻醉与呼吸重症研究所、山东省麻醉医学临床医学研究中心，山东 济南；任译延, 李明慧：山东第一医科大学第一附属医院(山东省千佛山医院)麻醉科、山东省麻醉与呼吸重症研究所、山东省麻醉医学临床医学研究中心，山东 济南；山东大学齐鲁医学院，山东 济南
关键词: 无痛消化内镜；气道管理；低氧血症；镇静麻醉；围术期安全；Painless Gastrointestinal Endoscopy； Airway Management； Hypoxemia； Sedation and Anesthesia； Perioperative Safety
摘要: 随着舒适化医疗及消化道早筛的普及，无痛内镜诊疗中由“共用气道”和深镇静引发的呼吸安全问题日益凸显。在保护性反射减弱的状态下，患者极易发生舌后坠、上气道梗阻及低氧血症，尤其对于高龄、肥胖及合并心肺疾病的高危人群，气道管理的质量直接决定了诊疗的安全与连续性。近年来，临床研究已从单一的补救性吸氧转向基于术前风险评估、术中多维度监测以及个体化氧疗通气装置(如HFNC、内镜专用喉罩及改良咬口)的精准干预模式。本文通过系统综述风险特征、评估路径、监测技术及特殊人群的管理要点，旨在为临床麻醉实践提供更为科学、规范的个体化气道保障策略。
Abstract: With the increasing adoption of comfortable medical care and early screening for gastrointestinal tumors, respiratory safety during sedated endoscopy has become a critical concern due to the challenge of a “shared airway” and the suppression of protective reflexes. Patients under sedation are prone to adverse events such as tongue fallback, upper airway obstruction, and hypoxemia, with risks significantly elevated in elderly, obese, and cardiopulmonary-impaired populations. Consequently, airway management has evolved from reactive rescue to a proactive, individualized approach integrating preoperative risk stratification, multi-dimensional intraoperative monitoring, and advanced oxygenation or ventilation devices—such as high-flow nasal cannula (HFNC), endoscopic laryngeal masks, and specialized bite blocks. By reviewing risk characteristics, assessment protocols, monitoring technologies, and management strategies for special populations, this article aims to provide a standardized clinical reference for enhancing procedural safety and diagnostic quality.
文章引用：朱叶, 尤琦, 任译延, 李明慧, 吴剑波. 无痛消化内镜麻醉气道管理的研究现状与进展[J]. 临床医学进展, 2026, 16(5): 2604-2617. https://doi.org/10.12677/acm.2026.1652071

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