呼吸道硬结病致瘢痕性喉狭窄的手术治疗

目的：探讨呼吸道硬结病致瘢痕性喉狭窄的临床特点和治疗方法。方法：回顾性分析7例导致瘢痕性喉狭窄的呼吸道硬结病的临床资料和治疗方法。结果：对4例单纯喉瘢痕性喉狭窄者，行喉裂开成形术，术后随访7-14年，无复发；喉及颈段气管瘢痕性狭窄2例，行喉气管成形腔内扩张术和舌骨肌瓣成形术各1例，术后分别随访6年和8年，均无复发；1例声门下狭窄患者术后声门下腔宽敞，但术后3个月复查时，肉芽肿病变增生致声门下闭锁，手术失败。结论：瘢痕性喉狭窄应根据不同的病变部位采取相应的手术方式，术中须避免过多的粘膜损伤，以防再度狭窄；对严重的喉气管狭窄者应用粘膜瓣、骨肌瓣等组织充分增加狭窄部的管壁以解除狭窄。

Surgery for scarring laryngeal stenosis involved with respiratorium scleroma

Objective: To study the clinical manifestation and treatment of laryngeal stenosis. Method: The clinical data of seven patients with cicatricial laryngeal stenosis involved with respiratorium scleroma were retrospectively reviewed. Results: Of them, 6 cases had laryngeal obstruction in the first degree and 1 case in the second degree. Four cases of simple cicatricial laryngeal stenosis had no relapse after surgery for 7 to 14 years; 2 cases of cicatricial stenosis mainly in the larynx and neck were subjected to enlargement of the laryngeal cavity and reconstruction surgery of the tongue bone flap also had no relapse for 6 to 8 years; 1 case of subglottic stenosis had hypolarynx atresia at 3 months after surgery. Conclusions： Cicatricial laryngeal stenosis should be operated on. In operation, mucous membrane must not be greatly injured and the mucous membrane flap or bone flap may be used to relieve laryngeal stenosis in serious patients.