改良气管切开术在吸入性损伤抢救中的应用  

Application of modified tracheotomy in inhalation injury

作　　者：张仁贤[1] 谭成勋[1] 包明全[1] 朱晓宁[1] 刘玉涛[1] 朱向阳[1] 张同良 

机构地区：[1]潍坊医学院附属莱阳中心医院耳鼻咽喉科,山东莱阳265200 [2]莱阳卫生学校

出　　处：《山东大学基础医学院学报》2004年第3期173-174,共2页Journal of Preclinical Medicine College of Shandong Medical University

摘　　要：目的 :探讨治疗重度吸入性损伤患者下呼吸道黏膜大面积坏死及清除脓血痂的有效方法。方法 :应用改良气管切开术抢救治疗重度吸入性损伤 12例。常规气管切开暴露颈段气管 3～ 5环 ,以颈 4环为中心 ,上下弧形切除少许气管软骨 ,长度不超出 2个气管环 ,分别缝合同侧的皮肤与气管切口 1～ 2针 ,插入气管套管。结果 :改良气管切开术可随时取管 ,方便纤维支气管镜检查 ,及时清除下呼吸道阻塞物 ,预防发生再窒息 ,12例患者无 1例因呼吸道阻塞而死亡。结论 :改良气管切开术不仅解除了喉梗阻 ,而且可观察下呼吸道病变及能有效。Objetive:To explore the method of patients with severe in inhalation injury to clean purs crust and sphacelous of lower respiratory tract.Method:Twelve cases with severe inhalation injury were performed modified tracheotomy. The third to fifth tracheod rings were explored as conventional tracheotomy. With the fourth ring being center of incision, small amont of cartilage was cut archnise less than two rings. The tracheal incisional margin was sutured with homolateral skin incision, then intubation. Result: Modified tracheotomy was convenient for fiberbronchoscopy and cleaning lower respiratory tract. None of the 12 cases died because of airway obstraction. This method could prevent asphyxia.Conclusion: Modified tracheotomy is a safe and efficient method of reliefing laryngemphraxis, examing and cleaning of lower respiratory tract.

关 键 词：吸入损伤 气道阻塞 气管切开术 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]