Difficulties and countermeasures in airway management for patients with severe pneumonia
重症肺炎患者气道管理难点与对策

摘要

重症肺炎患者气道管理存在解剖病理复杂、技术操作局限、多学科协作难度大等诸多难题。气道解剖变异和炎症反应引起气道阻力升高、分泌物潴留；人工气道的建立和机械通气策略的实施面临着技术瓶颈；医护团队权责划分模糊，感染防控和气道管理措施存在风险叠加，镇静镇痛策略对于气道功能的影响错综复杂。需采取优化团队协作，平衡风险和干预措施以及建立个体化镇静方案的策略来促进气道管理质量的提高。

Abstract

There are many difficulties in airway management of patients with severe pneumonia, such as complex anatomy and pathology, limited technical operations, and great difficulty in multidisciplinary collaboration. Airway anatomical variations and inflammatory responses cause increased airway resistance and secretion retention. The establishment of artificial airways and the implementation of mechanical ventilation strategies are facing technical bottlenecks. The division of rights and responsibilities among the medical team is ambiguous. There is a risk superposition in infection prevention and control and airway management measures. The impact of sedation and analgesia strategies on airway function is complex. Strategies such as optimizing team collaboration, balancing risks and intervention measures, and establishing individualized sedation programs need to be adopted to promote the improvement of airway management quality.