自制喉扩张管治疗外伤性喉气管狭窄  

Treatment of traumatic laryngotracheal stenosis with a self-made laryngeal dilator

作　　者：刘邦华[1] 孔维佳[1] 汪吉宝[1] 汪广平[1] 毕胜斌[1] 杨成章[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院耳鼻咽喉-头颈外科,武汉430022

出　　处：《中华创伤杂志》2005年第5期372-374,共3页Chinese Journal of Trauma

摘　　要：目的研究自制喉扩张管治疗外伤性喉气管狭窄的治疗效果,探讨放置喉扩张管的时限。方法62例外伤性喉气管狭窄患者,分为两组。第一组52例,为初次行喉扩张管治疗的患者。第二组10例,为行喉扩张管治疗失败后再次行喉扩张管治疗的患者。气管插管全身麻醉下行颈前正中喉气管切开,尽量切除喉气管内瘢痕组织,置入喉扩张管。结果第一组患者术后9-12个月全部拔除喉扩张管,呼吸通畅,发音较好,劳动力恢复。第二组患者拔管后3-4个月出现再狭窄,再次行喉扩张管治疗后顺利拔管,带管期间无严重并发症,如呼吸道阻塞的发生。随访1-10年,来发现再次喉气管狭窄患者。结论自制喉扩张管制作简单、方便,治疗效果良好,无排斥反应。喉扩张管的留置时间至少应在9-12个月以上。Objective To study the treatment effect of self-made laryngeal dilator in treatment of traumatic laryngotracheal stenosis and investigate the dwell duration of the laryngeal dilator. Methods A total of 62 cases of traumatic laryngotracheal tenosis were divided into two groups, ie, first group (52 cases, treated with the laryngeal dilator for the first time) and second group ( 10 cases, treated with the laryngeal dilator again after the failure in the first operations). In laryngotrachectomy, scar tissue was resected as much as possible and the laryngeal dilator placed in laryngeal cavity. Results Cases in the first group were decannulated 9-12 months after operation and could breathe freely, speak well and work. Laryngotracheal tenosis recurred 3-4 months after decannulation in the cases in the second group that was treated with the laryngeal dilator again and decannulated successfully. During the stenting time, no serious complications such as airway obstruction happened. The follow-up for 1-10 years showed no laryngotracheal tenosis recurrence. Conclusions The laryngeal dilator is made simply and conveniently and can win satisfactory outcome in treatment of laryngotracheal stenosis without reject reaction. The stenting time should be more than 9-12 months.

关 键 词：外伤性喉气管狭窄 扩张管 自制 气管插管全身麻醉 治疗效果 严重并发症 呼吸道阻塞 气管切开 瘢痕组织 呼吸通畅 排斥反应 留置时间 患者 再次 失败后 气管内 劳动力 再狭窄 拔管后 治疗后 未发现 

分 类 号：R767[医药卫生—耳鼻咽喉科]