临床耳鼻咽喉头颈外科杂志
臨床耳鼻嚥喉頭頸外科雜誌
림상이비인후두경외과잡지
JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2010年
3期
97-100
,共4页
李友忠%卢永德%杨新明%伍伟景%黎景佳%贺湘波
李友忠%盧永德%楊新明%伍偉景%黎景佳%賀湘波
리우충%로영덕%양신명%오위경%려경가%하상파
气管断裂%手术%气管切开术%并发症
氣管斷裂%手術%氣管切開術%併髮癥
기관단렬%수술%기관절개술%병발증
tracheal rupture%surgery%tracheotomy%complications
目的:探讨颈段闭合性气管断裂的临床表现及治疗.方法:回顾近10年间颈段闭合性气管断裂患者的临床表现、诊断及治疗.对临床上该病易发生的问题、手术关键点及术后恢复情况进行分析.41例急性颈段闭合性气管断裂患者,在24~48 h行紧急气管切开或麻醉插管、气管修复术,术后26例未保留气管导管,48 h内拔除麻醉插管;15例术后保留气管导管,其中术后2周12例成功拔管,另3例因气管、喉断裂伤术后狭窄不能拔管,其中2例再次行手术修复治愈,1例进行支架置入.结果:28例患者术后呼吸、发声、吞咽功能均恢复正常;10例术后呼吸、吞咽功能均恢复,但有声嘶,2~3个月后发声基本恢复,然声带活动差;另3例患者,术后呼吸、吞咽功能均恢复,但仍有声嘶.结论:颈段闭合性气管断裂早诊断并及时行结构与功能修复术,是抢救生命和避免气管狭窄的关键.
目的:探討頸段閉閤性氣管斷裂的臨床錶現及治療.方法:迴顧近10年間頸段閉閤性氣管斷裂患者的臨床錶現、診斷及治療.對臨床上該病易髮生的問題、手術關鍵點及術後恢複情況進行分析.41例急性頸段閉閤性氣管斷裂患者,在24~48 h行緊急氣管切開或痳醉插管、氣管脩複術,術後26例未保留氣管導管,48 h內拔除痳醉插管;15例術後保留氣管導管,其中術後2週12例成功拔管,另3例因氣管、喉斷裂傷術後狹窄不能拔管,其中2例再次行手術脩複治愈,1例進行支架置入.結果:28例患者術後呼吸、髮聲、吞嚥功能均恢複正常;10例術後呼吸、吞嚥功能均恢複,但有聲嘶,2~3箇月後髮聲基本恢複,然聲帶活動差;另3例患者,術後呼吸、吞嚥功能均恢複,但仍有聲嘶.結論:頸段閉閤性氣管斷裂早診斷併及時行結構與功能脩複術,是搶救生命和避免氣管狹窄的關鍵.
목적:탐토경단폐합성기관단렬적림상표현급치료.방법:회고근10년간경단폐합성기관단렬환자적림상표현、진단급치료.대림상상해병역발생적문제、수술관건점급술후회복정황진행분석.41례급성경단폐합성기관단렬환자,재24~48 h행긴급기관절개혹마취삽관、기관수복술,술후26례미보류기관도관,48 h내발제마취삽관;15례술후보류기관도관,기중술후2주12례성공발관,령3례인기관、후단렬상술후협착불능발관,기중2례재차행수술수복치유,1례진행지가치입.결과:28례환자술후호흡、발성、탄인공능균회복정상;10례술후호흡、탄인공능균회복,단유성시,2~3개월후발성기본회복,연성대활동차;령3례환자,술후호흡、탄인공능균회복,단잉유성시.결론:경단폐합성기관단렬조진단병급시행결구여공능수복술,시창구생명화피면기관협착적관건.
Objective:To study the clinical manifestations and treatments of closed injuries of the cervical trachea.Method:We carried out a retrospective study of the clinical manifestations, diagnosis and treatment of patients with closed injuries of the cervical trachea that have been treated in our hospital over the last ten years. We analyzed commonly occurring clinical problems, key points of surgical treatment, and postoperative recovery. Fourty-one patients with acute closed injuries of the cervical trachea underwent emergency tracheotomy or anesthesia orotracheal intubation and surgical repair of the trachea within 24 to 48 hours. Twenty six patients had their tracheotomy tubes extubated after surgery and had their anesthesia orotracheal tubes extubated within 48 hours postoperatively; tracheotomy tubes remained in the airway in 15 patients postoperatively, and of them, 12 had extubation successfully in 2 weeks postoperatively, while the remaining 3 were left intubated due to laryngotracheal stenosis. Among the 3, 2 underwent further surgical repair and recovery, and 1 had a stent inserted.Result:Twenty-eight patients fully recovered postoperatively. Ten patients mostly recovered postoperatively exception for hoarseness, and their fundamental phonation function recovered within 2 to 3 months but with poor movement of the vocal cords. The breathing and swallowing function of the other 3 patients recovered after the surgery, but they suffer from hoarseness.Conclusion:In the treatment of closed disruption of the cervical trachea, prompt diagnosis and timely surgical repair of the structure and function of the trachea are key to saving the patients' lives and avoiding tracheal stenoses.