关键词: 腭裂, 困难气管内插管, 术前评估

Abstract:

Summary：The anesthesia of infancy patients requires that doctors have a good knowledge of the surgery procedures and anatomic characters，as well as the relationship between cranio-maxillofacial malformation and intubation problems. It is of great importance to evaluate the factors which make intubation difficult，such as patient history，physical examination，special radiology examination and laryngoscope examination. The methods of preoperative evaluation of difficult tracheal intubation should be used associatedly and synthetically. The author puts forward a series of convenient and practical methods on how to evaluate intubation difficulties preoperatively，the details being as follows. Looking or watching：craniofacial malformation，micromandible，abnormal occlusion and other malformation of vertebra and extremity，and infundibular chest often indicate breath obstascle. Hearing or listening：listen carefully when patients are talking or crying，hoarseness indicate laryngeal wed;laryngeal stridor often comes with incomplete calcified cartilage epiglottica;patients with Robin syndrome often sounds like having something in their mouth. Asking：ask the parents wether the baby had suffocation when born，which often comes with micromandible and cerebral palsy dysgnosia，and whether there is prostration，snore or airway obstraction during sleep. Ask whether they have feeding difficulty. Checking：check the patient about mallampati，neck mobility，distance between mental and thyroid cartilage，and protraction occlusion. Use laryngoscope and radiological examination to see whether there is problem with cervical spine，laryngeal or pharynx.

Key words: cleft palate, difficult endotracheal intubation, preoperative evaluation