开放性喉外伤的救治体会

Treatment of open laryngeal trauma

摘要:

目的 探讨开放性喉外伤的救治方法。方法 回顾2000年4月~2008年12月收治的36例开放性喉外伤患者的临床资料，并分析其救治体会。36例开放性喉外伤患者均行气管切开加创伤探查术，对有严重喉气管损伤者行喉气管成形术。结果36例患者术后均拔管，无死亡病例，1例并发喉狭窄。1例喉软骨缺损严重患者在取除喉模4周后出现呼吸困难行支气管镜下肉芽气化切除，4周后复查呼吸困难缓解，声门下光滑。结论在开放性喉外伤的救治中，应以保持患者呼吸道通畅、抢救患者生命为原则，尽可能减少并发症，恢复喉功能。

Abstract:

Objective To study the treatment of open laryngeal trauma.MethodsClinical data of 36 patients with open laryngeal trauma from April 2000 to Dec 2008 was analyzed respectively. All the patients underwent tracheotomy and trauma exploration. The patients with serious laryngotracheal trauma underwent laryngotracheal reconstruction.ResultsNo patients died. Extubation was achieved in all the patients. One case suffered from laryngeal stenosis due to infraglottic granulation tissue 4 weeks after removal of laryngeal stent. 4 weeks after gasification resection of granulation tissue, dyspnea got relieved with smooth infraglottic portion.ConclusionsIn the treatment for open laryngeal trauma, patency of airway is essential. The therapeutic principles include life rescue as priority, recovery of laryngeal function and prevention of complications.