以喉狭窄首发的黏膜类天疱疮1例分析  

Mucous membrane pemphigoid with laryngeal stenosis:1 case report

作　　者：张军军 梁乐平 ZHANG Jun-jun;LIANG Le-ping(Department of Otolaryngology Head and Neck surgery,Tangdu Hospital of Air Force Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学唐都医院耳鼻咽喉头颈外科,710038

出　　处：《中国实用医药》2023年第3期135-137,共3页China Practical Medicine

摘　　要：喉狭窄是耳鼻咽喉头颈外科较为少见的一种疾病,主要表现为喉喘鸣、呼吸困难、声嘶甚至失声等症状。其病因多样,包括医源性损伤、颈部创伤、自身免疫性疾病以及其他因素等。该疾病治疗较为棘手,至今尚无十分满意的治疗方法,临床上需遵循对因治疗的原则。若狭窄原因为医源性损伤或颈部创伤,结合狭窄的范围及患者的具体情况可考虑手术治疗,若狭窄原因为炎性疾病或其他原因,密切观察患者生命体征,排除窒息可能性后以积极治疗原发病为主,切勿盲目手术。本文报道1例首发症状为呼吸困难的黏膜类天疱疮(MMP)患者并最终经喉镜确诊为喉狭窄的病例,为抢救生命,急诊予以气管切开术。以此提醒广大临床医生,接诊喉狭窄患者需多方位思考,积极寻找病因并正确治疗。Laryngeal stenosis is a kind of disease of otolaryngology head and neck surgery,its incidence rate is relatively low.The disease mainly focus on laryngeal stridor,breathing difficulty,hoarseness,and other symptoms,which has multiple causes,including the iatrogenic injury,neck trauma,autoimmune diseases and other factors,etc.This disease treatment is more difficult,so far there is no satisfactory treatment method.Thus,the surgeon need to follow the principle of etiological treatment.If narrow causes for iatrogenic injury or neck trauma,doctors consider surgery under the specific condition of narrow scope and patients.If narrow reasons for autoimmune diseases,the doctors closely observe the patient vital signs,after ruled out asphyxia possibility,the disease should be actively treated with the primary disease,rather than surgery as soon as possible.This paper reported one patient of mucous membrane pemphigoid(MMP)leading to result in laryngeal stenosis,the patient’s first symptom is dyspnea,and a tracheotomy was performed in an emergency to save life.This is a reminder to clinicians that they should be multi-dimensional thinking,and actively seek the cause of laryngeal stenosis as well as correct treatment.

关 键 词：黏膜类天疱疮 喉狭窄 呼吸困难 气管切开 

分 类 号：R767[医药卫生—耳鼻咽喉科]