支撑喉镜下术后并发舌下神经麻痹临床分析  

Clinical analysis of hypoglossal nerve paralysis after laryngoscopy

作　　者：廖红明 蒋玉欢 何本超[1] Liao Hongming;Jiang Yuhuan;He Benchao(Department of ENT,Tianmen first people's Hospital,Hubei,Tianmen,431700,China)

机构地区：[1]天门市第一人民医院耳鼻咽喉头颈外科,湖北天门431700

出　　处：《中国医学文摘（耳鼻咽喉科学）》2020年第2期108-109,共2页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：目的探讨支撑喉镜下术后并发舌下神经麻痹的预防措施及解决方法,分析舌下神经麻痹的原因,最大限度减少舌下神经麻痹的发生。方法收集我科在静脉麻醉气管插管条件下行支撑喉镜下声带病损切除术,术后出现舌下神经麻痹的患者2例;分析其疗效。结果1例患者术后第1天开始出现舌体麻木及舌体运动轻度受限,无面瘫,1月左右基本恢复。1例患者术后当天出现,自觉右侧舌体肿胀,伸舌时舌肌运动异常,吐字不清,未影响正常生活,无面瘫,术后3月左右基本恢复。结论1.暴露困难、手术时间延长、支撑喉镜片长时间压迫舌体将有可能导致舌下神经麻痹发生的可能;2.气管导管套囊的合适选择可能会减少舌下神经麻痹发生的机率。3.术者对支撑喉镜的熟练掌握也是减少舌下神经麻痹发生的重要因素。Objective To explore the preventive measures and solutions of hypoglossal nerve paralysis after laryngoscope surgery,analyze the causes of hypoglossal nerve paralysis,and minimize the occurrence of hypoglossal nerve paralysis.Methods To collect the vocal cord lesion resection under the support laryngoscope under the condition of intravenous anesthesia and tracheal intubation in our department.Postoperative hypoglossal nerve palsy occurred in 2 patients.the curative effect was analyzed.Results One patient had tongue numbness on the first day after operation,slight limitation of tongue movement and no facial paralysis,and basically recovered in about 1 month;One patient presented with swelling of the right tongue on the day after operation,abnormal movement of the tongue muscle,unclear articulation,no influence on normal life,no facial paralysis,and basically recovered about 3 months after operation.Conclusions Difficulty of exposure,prolonged operation time and prolonged pressure of lingual body by supporting laryngoscope lenses may lead to hypoglossal nerve paralysis;Appropriate selection of endotracheal conduit capsules may reduce the incidence of hypoglossal paralysis;The proficiency of laryngoscope support is also an important factor to reduce the occurrence of hypoglossal nerve paralysis.

关 键 词：支撑喉镜 舌下神经 声带息肉 麻痹 

分 类 号：R47[医药卫生—护理学]