嗓音显微外科手术常见麻醉并发症452例分析

目的：探讨嗓音显微外科手术治疗声带各种良性病变（声带小结、声带息肉、Reinke水肿、声带囊肿等）麻醉并发症的防治方法。方法：对452例声带各种良性病变的患者在插管复合静脉麻醉下，施行支撑喉镜显微镜下嗓音显微外科手术，观察其麻醉并发症。结果：损伤鼻和（或）咽部黏膜导致活动性出血14例，反射性迷走神经兴奋而导致心率迅速下降18例，环杓关节脱位3例，声带息肉脱落导致气管异物2例，插管时损伤声带导致声带插管性肉芽3例。结论：插管复合静脉麻醉下支撑喉镜显微镜下嗓音显微外科手术治疗声带各种良性病变安全、可行，关键在于术中的操作，可使麻醉并发症降至最低。

Prevention and cure of common anesthetic complications of phonomicrosurgery: a report of 452 cases

Objective：To explore how to treat anesthetic complications of various kinds of benign vocal cords lesion,including chorditis nodulosa,polyp of cord,Reinke＇s edema and vocal cyst during phonomicrosurgery. Methods：452 patients with various kinds of benign lesion were performed microsargery with self-retaining laryngoscope by trachea intubation along with venery anesthesia. Anesthetic complications were observed. Results：Active bleeding caused by damaging mucous membrane of nose and/or pharyngeal portion had 14 cases, heart rate lastly decrease caused by exciting of reflectivity vagus 18 cases,dearticulation of articulatio cricoarytenoidea 3 cases,foreign body in trachea caused by polyp of cord 2 cases,bilateral laryngeal granulomas after endotracheat intubation 3 cases. Conclusion ：Surgery for benign diseases of vocal cord with phonomicrosurgery through sustaining laryngoscope by trachea intubation along with venery anesthesia is an operating with safety, feasible. The key point is the operation which can reduce the anesthetic complications.