光索辅助微创气管切开术在颌面肿瘤术的应用  

Clinical application of Light Wand percutaneous dilatational tracheostomy in oral and maxillofacial cancer resection

作　　者：吕翔[1] 徐辉[1] 姜虹[1] 朱也森[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院麻醉科,200011

出　　处：《上海医学》2011年第10期750-752,I0001,共4页Shanghai Medical Journal

摘　　要：目的探讨光索辅助微创气管切开术在颌面肿瘤术的应用价值。方法对25例行颌颈肿瘤根治及远位皮瓣修复术的患者,手术结束时采用盲探气管插管装置的组件光索来辅助定位气管导管头端,将其退至第3气管软骨环处并在第3与第4气管软骨环间行微创气管切开术。结果 25例患者均按上述方法顺利完成手术,操作平均用时为(8.6±1.1)min,术中未发生明显的即刻并发症,术后随访患者均未出现声音嘶哑和明显气道狭窄,也无任何疼痛主诉。采用该方法操作后的气切瘢痕愈合较传统方法平整、美观。结论光索辅助微创气管切开术操作简便,成功率高,手术并发症少,减轻了患者的痛苦,在口腔颌面肿瘤术中有广泛的应用前景。Objective To explore the application value of Light Wand percutaneous dilatational tracheostomy in oral and maxillofacial tumor resection. Methods Twenty-five patients who were to receive radiation therapy for head and neck cancer and reconstruction with distant flap were selected for this study. First, the Light Wand, which was a part of the blind tracheal intubation device, was used to help the endotracheal tube backing to the third tracheal cartilage ring, and then the percutaneous dilatational tracheostomy was done between the third and the fourth tracheal cartilage rings. Results All the 25 patients successfully underwent the operation, and the mean time of the operation was （8.6 ± 1. 1 ） min. No obvious intraoperative complications occurred. Hoarseness and narrowed airway were not observed and no complaints of pain were reported after the operation. Compared with traditional methods, the incisions of our patients were more smooth and cosmetic. Conclusion Light Wand assisted percutaneous dilatational tracheostomy can be easily operated and relieve patient suffering; it also has high success rate and low complications. So it can be widely apPlied in oral and maxillcfacial surgery in the future. （Shanghai Med J, 2011, 34： 750-752）

关 键 词：盲探气管插管装置 经皮扩张气管切开术 口腔颌面外科术 

分 类 号：R739.8[医药卫生—肿瘤]