单侧声带横断与声带部分切除术治疗双侧声带外展麻痹

Treatment of bilateral vocal cord paralysis by unilateral vocal cord transection and partial cordectomy

摘要:

目的 探讨用单侧声带横断与声带部分切除术治疗双侧声带外展麻痹的疗效与临床应用价值。方法 对9例继发性双侧声带外展麻痹的患者，采用支撑喉镜下单侧声带横断与声带部分切除术进行治疗，通过术后的观察随访，对该术式的临床效果进行分析与评估。结果8例患者气管切开后行单侧声带横断与声带部分切除术，其中7例患者术后2个月安全拔管，1例不能拔管的患者经过再次手术2个月后安全拔管；另1例Ⅰ度呼吸困难患者经口气管内插管后行声带手术。所有患者行单侧声带横断与声带部分切除术后随访半年以上呼吸困难完全缓解；术后声嘶程度均较前加重，但不影响日常的生活交流。结论单侧声带横断与声带部分切除术治疗双侧声带外展麻痹的方法，不需要昂贵器械，简单实用，临床疗效良好，并发症少，值得在基层医院中推广应用。

Abstract:

Objective To study the curative effect and clinical application of unilateral vocal cord transection and partial cordectomy on the treatment of bilateral vocal cord paralysis.Methods9 patients suffering from secondary bilateral vocal cord paralysis received unilateral vocal cord transection and partial cordectomy under direct laryngoscope. All the patients were followed up postoperatively and the curative effect was analyzed.ResultsOne patient received the surgical procedures without tracheotomy and got complete remission of dyspnea postoperatively. 8 patients received tracheotomy. 7 of them got extubated 2 months postoperatively and 1 was extubated after the revision surgical procedure. Dyspnea was completely relieved in all patients. Although hoarseness got aggravated, the conversational voice was competent enough for daily life.ConclusionsUnilateral vocal cord transection and partial cordectomy has good effect on the treatment for bilateral vocal cord paralysis. With advantages of unnecessity of expensive instruments, simplicity in methodology, good clinical effect and rare surgical complications, these procedures are worthy of recommendation in general hospitals.