喉气管重度瘢痕狭窄18例临床分析  

Severe laryngotracheal cicatricial stenosis of 18 cases

作　　者：黄永久[1] 鲍学礼[1] 孔旭辉[1] 储九圣[1] 

机构地区：[1]江苏省泰州市人民医院耳鼻咽喉头颈外科,江苏泰州225300

出　　处：《中国当代医药》2010年第29期22-23,共2页China Modern Medicine

摘　　要：目的:探讨喉气管重度瘢痕狭窄的不同治疗方法及其效果。方法:对18例重度喉气管狭窄的患者应用不同方法行喉气管重建及扩张,其中,气管切开瘢痕切除5例,气管袖状切除2例,支撑喉镜下CO2激光瘢痕切除7例,瘢痕切除+双蒂肌皮瓣重建4例;12例行T型管扩张,4例行镍钛记忆合金支架扩张,2例不扩张。结果:18例患者随访2～6年,3例行二次T型管扩张,2例短期内再狭窄,1例2年后再狭窄,15例(83.3%)疗效巩固。结论:喉气管重度瘢痕狭窄应根据病情选择手术方法,支撑器可有效预防再狭窄,在确保疗效的前提下应尽可能选择简单、微创的治疗方法。Objective：To investigate the severe cicatricial laryngotracheal stenosis and the effect of different treatments.Methods：18 patients with severe laryngeal and tracheal application of different methods in patients with laryngeal tracheal reconstruction and expansion,in which tracheotomy scar excision in 5 cases,tracheal sleeve resection in 2 cases,suspen sion laryngoscope under the CO2 laser scar removal in 7 cases,scar removal ＋ double pedicled muscle flap in 4 cases;12 routine T-tube expansion,and 4 cases of nickel titanium shape memory alloy stent expansion,2 cases of non-expansion.Results：18 patients followed up for 2 to 6 years,3 underwent a second T-tube expanded,two cases of restenosis in the short term,one case of restenosis after 2 years,15 patients（83.3%） effect of the consolidation.Conclusion：Severe laryngotracheal cicatricial stenosis surgery in accordance with condition selection method is effective in preventing stent restenosis,in ensuring the efficacy of choice as far as possible under the premise is simple,minimally invasive treatment.

关 键 词：喉狭窄 气管狭窄 喉重建术 气管重建术 

分 类 号：R76[医药卫生—耳鼻咽喉科]