喉气管外伤及狭窄的治疗  

Therapy for Laryngotracheal Injury and Stenosis

作　　者：陈江波[1] 孙虹[1] 

机构地区：[1]中南大学湘雅三医院耳鼻咽喉科,湖南长沙410013

出　　处：《医学临床研究》2008年第7期1227-1228,共2页Journal of Clinical Research

摘　　要：【目的】探讨喉外伤及狭窄的不同类型的临床治疗方法及效果。【方法】15年来收治各类喉外伤及狭窄患者38例。其中9例闭合性喉腔软组织伤,或合并软骨骨折而无移位,采用药物保守治疗,18例喉外伤颈部有开放性损伤伴有喉气管软骨损伤,或颈部无开放性损伤伴有喉气管软骨损伤,进行清创缝合,开放手术复位骨折,留置硅胶喉扩张管支撑,11例喉气管瘢痕狭窄采用瘢痕切除留置硅胶喉扩张管支撑,喉气管裂开肋软骨移植术,栅栏状喉气管成形术等方法治疗。【结果】37例患者呼吸通畅、发音满意,劳动力恢复,1例患者需终身保留气管造口。【结论】喉气管外伤应尽早明确诊断,早期治疗。喉气管外伤后瘢痕狭窄患者,根据狭窄部位和程度采取瘢痕切除留置硅胶喉扩张管支撑,栅栏状喉气管成形术及喉气管裂开肋软骨移植术,效果比较满意。[Objective]To explore the different methods of therapy in different kinds of injury and/or cicatricial stenosis of larynx. [Methods] There were 38 patients with acute injury or stenosis of larynx treated in the past 15 years. Nine patients with minor injury or with non-displaced cartilage fracture were treated by medicine and closely observed. Eighteen patients with acute opening laryngeal injury combined with displaced cartilage fracture were operated and laryngeal dilators were kept in the laryngeal cavity for at least 3 months. Eleven patients who had post-traumatic cicatricial stenosis of the larynx were treated by fence form laryngeal reconstruction, flap reconstruction or rib cartilage transplantation according to the extent and degree of the affected lesions. [Results]Thirty seven cases in all patients attained satisfactory functions in breath, pronunciation, and swallow. However, One failed because of severe cicatricial stenosis. [Conclusion]Early diagnose and treatment is the most important for laryngeal injury. For the patients with post-traumatic cicatricial stenosis, fence form laryngotracheal reconstruction, laryngeal dilator, and rib cartilage transplantation could be useful according the extent and degree of the affected lesions.

关 键 词：创伤和损伤/治疗 喉/损伤 气管/损伤 气管狭窄 

分 类 号：R767.8[医药卫生—耳鼻咽喉科]