闭合性颈段气管断裂伤的临床表现与治疗  

Clinical features and treatment of closed rupture of cervical trachea

作　　者：李友忠[1] 卢永德[1] 杨新明[1] 伍伟景[1] 黎景佳[1] 贺湘波[1] 

机构地区：[1]中南大学湘雅二医院耳鼻咽喉头颈外科,长沙410011

出　　处：《临床耳鼻咽喉头颈外科杂志》2010年第3期97-100,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：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24～48h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,48h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。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.

关 键 词：气管断裂 手术 气管切开术 并发症 

分 类 号：R768.12[医药卫生—耳鼻咽喉科]