喉外伤的急救及喉狭窄的预防与治疗  

Emergency Treatment of Laryngeal Injuries and Prevention and Management of Laryngeal Stenosis

作　　者：张莉[1] 彭诗东[1] 孙学威[1] 徐明义[1] 

机构地区：[1]内蒙古医学院附属医院耳鼻喉科,内蒙古呼和浩特010050

出　　处：《内蒙古医学杂志》2005年第5期403-405,共3页Inner Mongolia Medical Journal

摘　　要：目的:通过对32例喉外伤救治情况分析,得出喉外伤合理的救治方法,总结出喉狭窄预防与治疗方法.方法:回顾性分析了1982年11月～2003年3月收治的32例急诊喉外伤的临床资料,其中开放性喉外伤26例,闭合性喉外伤6例,对25例进行了喉探查术.结果:25例喉探查患者术后顺利拔管22例,拔管患者中声嘶6例,3例发生喉狭窄,其中1例经二次手术喉内放置硅胶管扩张后拔管,2例经治疗后仍不能拔管,1例死于颅脑损伤.结论:对喉外伤行急救处理时,尽量在一期重建喉的结构,对严重的闭合性喉外伤,尽早行手术探查.早期正确处理是防止喉狭窄的关键,喉裂开置喉膜扩张应为治疗喉狭窄的有效方法,但严重喉狭窄或伴有软骨缺失者效果不理想,应考虑用合适的移植材料进行喉成形术,可提高手术成功率.Objective:To analyze management of 32 cases with laryngeal injuries for improving surgical techniques in treatment of laryngeal injuries and prevention and treatment of laryngeal stenosis.Methods:Clinical data of 32 cases with laryngeal injuries form vovember 1982 to March 2003 were retrospectively analyzed.26 of 32 cases had open laryngeal injuries,6 had closed ones,25 were performed exploration.Results:Of 25 cases treated with exploration,22 cases underwent extubating sucessfully.Hoarse voice was present in 6 cases and laryngeal stenosis in 3 ones,1 of whom extulated after second operation of laryngeal dilation with silica gel tube,2 unable to extubate and 1 died as a result of craniocerebral injury.Conclusion:Laryngeal reconstruction should be recommended in emergency treatment of laryngeal injuries and early exploration be performed on severely colsed ones.Early propermanagement is the key for preventing laryngeal stenosis.Dilation of laryngeal membrance is effective in laryngeal cleft,but except for severe laryngeal stenosis and cartilage defect,in which laryngoplasty with suitable graft may improve the successful rate of operation.

关 键 词：喉外伤 喉狭窄 外科手术 

分 类 号：R767.8[医药卫生—耳鼻咽喉科]