婴幼儿环杓关节脱位的临床分析  

Clinical analysis of arytenoid dislocation in infants

作　　者：郭良芬[1] 邹宇[1] 陈曦 邓梦夏 黄亚萍[1] 陈婷 颜帅 Guo Liangfen;Zou Yu;Chen Xi;Deng Mengxia;Huang Yaping;Chen Ting;Yan Shuai(Department of Otolatyngology,Guangdong Women and Children Hospital,Guangzhou 510010,China)

机构地区：[1]广东省妇幼保健院耳鼻咽喉科,广州510010

出　　处：《国际耳鼻咽喉头颈外科杂志》2020年第5期270-273,共4页International Journal of Otolaryngology-Head and Neck Surgery

基　　金：广东省科技厅基金项R(2014A04040I040)。

摘　　要：目的探讨静脉吸入复合全麻联合利多卡因局麻在可视喉镜下杓状软骨闭合复位治疗环杓关节脱位的临床疗效。方法分析2018年2月~2019年10月间8例环杓关节脱位接受静脉吸入复合全麻联合利多卡因局麻下杓状软骨复位术的患者资料,其中全身麻醉气管插管导致7例,喉部肿物所致1例。所有患者均行电子纤维检查,见不同程度的声带运动障碍,其中7例为左侧,1例为双侧;杓状软骨向前移位者7例,向后侧移位者1例。静脉吸入复合全麻联合利多卡因局麻下,根据电子纤维喉镜和可视喉镜提示的脱位方位以剥离子进行复位,手术结束前即时进行复位效果评估。结果患儿术前有声音嘶哑、气促或呼吸困难,术中评估均复位成功,术后电子纤维喉镜复查声带运动恢复正常。结论婴幼儿环杓关节脱位时间长不是复位治疗的禁忌证;静脉吸入复合全麻联合利多卡因局麻的可视喉镜下杓状软骨复位是治疗婴幼儿环杓关节脱位的有效方法。Objective To investigate the clinical effect of arytenoid cartilage reposition un der Combined In travenous In halation and general anesthesia combined with lidoca ine local anesthesia.Methods From February 2018 to October 2019,the data of 8 patients accepted arytenoid cartilage reposition under Combined Intravenous Inhalation and general anesthesia combined with lidocaine local anesthesia were analyzed,including 7 cases caused by tracheal intubation under general anesthesia and 1 case caused by laryngeal nlass.All patients were examined with electronic fiber:there were different degrees of vocal cord movement disorders,including 7 cases on the left side and I case on both sides;7 cases with arytenoid cartilage displaced forward and 1 case backward.Under the local anesthesia of Intravenous Inhalation Combined with lidocaine,according to the dislocation position indicated by the electronic fiber laryngoscope and visual laryngoscope,the ion peeling was used for reduction,and the reduction effect was evaluated immediately before the end of the operation.Results The children had hoarseness,shortness of breath or dyspnea before the operation.All the patients were successfully reduced during the operation.After the operation,the moveme nt of vocal cord was restored to normal by electronic fiber laryngoscope.Conclusion The long time of arytenoid dislocation in infants is not a contraindication;The arytenoid cartilage reduction under laryngoscope under Intravenous Inhalation Combined with general anesthesia and lidocaine local anesthesia is an ef'fective method for the treatment of arytenoid dislocation in infants.

关 键 词：杓状软骨 脱位 闭合复位术 

分 类 号：R726.8[医药卫生—儿科]