可视喉镜在声门暴露困难患者喉显微手术中的应用

Application of video laryngoscope for microsurgery of larynx in patients with difficult laryngeal exposure

摘要:

目的探讨可视喉镜在声门暴露困难患者喉显微手术中的应用价值。方法回顾性分析2016年1月~2016年8月在我院采用可视喉镜辅助喉显微手术治疗的20例声门暴露困难的声带良性病变患者的临床资料，对患者的平均手术时间、术中平均出血量、术中牙齿松动发生率、软腭裂伤发生率以及术后疼痛评分进行分析。结果根据CormackLehane(CL)分级方法，20例患者中属于III级声门暴露困难者15例，IV级声门暴露困难者5例。所有患者的平均手术时间、术中平均出血量、术中牙齿松动发生率、软腭裂伤发生率以及术后疼痛平均评分分别为(17.20±3.33)min、(3.30±1.17)ml、0%（0/20）、0%（0/20）及(1.35±0.93)分。术后随访3~6个月，患者均无复发。结论可视喉镜在普通支撑喉镜下声门暴露困难患者的喉显微手术中声门暴露充分，手术时间短且围手术期并发症少，值得推广应用。

关键词:可视喉镜|支撑喉镜|喉显微手术|声门|暴露困难

Abstract:

ObjectiveTo explore the application value of video laryngoscope for microsurgery of larynx in patients with difficult laryngeal exposure.MethodsClinical data 20 patients with difficult laryngeal exposure and underwent microsurgery of larynx in Xiangya Hospital from Jan 2016 to Aug 2016 were analyzed retrospectively. The data analyzed included mean operation time, average bleeding volume, odontoseisis incidence, rate of soft palate damage and postoperative pain score.ResultsAccording to the CormackLehane (CL) grading method of difficult laryngeal exposure, 15 patients were classified as grade Ⅲ and 5 as grade Ⅳ. Of all the 20 patients, the average operating time was (17.20±3.33) min, and mean blood loss volume was (3.30±1.17) ml, odontoseisis incidence and rate of soft palate damage were both 0（0/20）, and the average postoperative pain score were (1.35±0.93). Postoperative followup for 3 to 6 months showed no recurrence.ConclusionWith advantages of full glottis exposure, shortened operation time and decreased perioperative complications, video laryngoscope is worth promoting for microsurgery of larynx in patients with difficult laryngeal exposure.

Key words:Video laryngoscope|Self-retaining laryngoscope| Laryngomicro surgery| Glottis|Difficult exposure