摘要
目的 探讨37年来收治的36例抢救性小儿气管插管出现的并发症及防治措施。方法对36例抢救性小儿气管插管的临床资料进行回顾性分析。结果插管后并发症有声带杓间区溃疡或肉芽肿8例,双声带麻痹伴声门下狭窄5例,声门下及气管狭窄10例,左声带麻痹4例,气管环切开口区瘢痕狭窄9例。经用全麻下扩张法、喉气管瘢痕切除重建、硅橡胶T形管支撑、环杓关节拨动、声带外展移位术和保守治疗3～6个月后,声嘶改善,呼吸困难、喉气管源性气喘消失,喉气管功能得以恢复。结论喉气管插管并发症是由于插管时体位不正确、创伤、留置时间过长、气囊压力过大及局部感染造成,选择恰当、准确、轻柔的手术操作是防治的主要手段之一。
Objective To discuss the complications induced by the endotracheal intubation and the preven- tion and treatment. Methods Thirtyandsix caseswere analyzed retrospectively. Results The complications in-duced by the endotracheal intubation included ulcer or granuloma in 8 cases, vocal cords paralysis with subglot-tic stenosis in 5 cases, subglottic and tracheal narrow-ness in 10 cases, left vocal cords paralysis in 4 cases and cartilaginess tracheales stenosis in 9 cases.We performed dilatation with general anesthesia,operative cicatrix abla-tion and reconstruction for laryngotracheal, 'T'sili-con-rubber cannulation,consequently shifting cricoary-taenoidea articulus,abducently tranlocating the vocal cords and having conservative therapies for 3 up to 6 months,the results showed that hoarseness was ameliorat-ed,dyspnea and asthma induced by laryngotracheal dis-eases disappeared,finally the laryngotracheal functions were recovered. Conclusion The cause of complications of endotracheal intubation in children are incorrect oper-ativeposition, trauma, excessive-pressure ofthe airbag and local inflammation .The suitable, accurate and mod-erate operation could avoid such complications.
出处
《耳鼻咽喉（头颈外科）》
2003年第4期223-225,共3页
Chinese Arch Otolaryngology-Head Neck Surg
