摘要
在儿科急救中，气管插管术及气管切开术后常遇到喉气管狭窄问题。对于急性的插管损伤，可尝试丝裂霉素C等药物治疗。已瘢痕形成的喉气管狭窄，则以手术治疗为主。病情较轻的患儿，可应用内镜下球囊扩张及激光手术等治疗方式，损伤较小，恢复较快，但有一定的复发率。对于狭窄范围较大，病情较重的患儿，大多需要应用喉气管重建、气管成型术、部分环状软骨气管切除术等开放性的手术方式来治疗。预防气管插管和气管切开带来的并发症，要选择合适的套管型号，插管期间套囊需间断放气。如气管内插管时间大于7 d，应尽早气管切开。
In pediatric emergency, we often encounter laryngotracheal stenosis after tracheal intubation and tracheotomy.For acute cannulation injury, mitomycin C and other drugs can be tried.And for laryngotracheal stenosis with mature scar, surgery is the main treatment.Children with mild illness can be treated by endoscopic balloon dilatation and laser surgery, with less injury and faster recovery, but with a certain recurrence rate.Most of the children with severe stenosis need to be treated with open surgery such as laryngotracheal reconstruction, slideplasty, partial cricotracheal resection and so on.To prevent complications caused by tracheal intubation and tracheotomy, the appropriate size of tube should be selected, and intermittent discharging is required during intubation.If the tracheal intubation is needed for longer than 7 days, tracheotomy should be performed as soon as possible.
作者
连欣(综述)
季文樾(审校)
Lian Xin, Ji Wenyue(Department of Otolaryngology, Shengjing Hospital of China Medical University, Shenyang 110004, China)
出处
《国际儿科学杂志》
2018年第10期786-788,793,共4页
International Journal of Pediatrics
关键词
小儿气道
气管插管
气管切开
喉气管狭窄
Pediatric airway
Tracheal intubation
Tracheotomy
Laryngotracheal stenosis
