颌面部手术后呼吸道梗阻原因及对策

目的 分析颌面部手术后呼吸道梗阻的原因，探讨保持呼吸道通畅的有效措施。方法 回顾性研究了2785例颌面部手术后患者的上呼吸道通畅情况及护理措施。对11例患者出现上呼吸道梗阻的原因进行分析，以探讨颌面部手术后保持呼吸道通畅的有效措施。结果 颌面部手术后上呼吸道梗阻的主要原因有术后声带水肿，喉炎，喉水肿（63.6%)。分泌物堵塞上呼吸道（63.6%)，舌后坠（36.3%)，咽腔缩小（36.3%)，呼吸道周围软组织水肿和血肿（54.5%)等。结论 颌面部手术后存在多种因素可引起患者上呼吸道梗阻，针对手术部位和术式的不同仔细观察病情，采取适当的体位，应用合适的绷带技术，及时清除呼吸道分泌物，进行人工气道温湿化等是保持颌面部手术后上呼吸道通畅的有效方法。

Cause and Prevention of Respiratory Tract Obstruction after Maxillofacial Operation

Objective To Analyse the cause respiratory tract obstruction after maxillofacial operation, to find out an efficient measure to keep respiratory unobstructed.Methods To retrospectively study the state and nursing of upper respiratory tract in 2785 cases of patients after maxillofacial operation. Then analyse the cause of respiratory tract obstruction of 11 patients, to find out a efficient measure to keep the respiratory tract unobstructed. Results The mainly causes of upper respiratory obstructure are vocal cord oedema, laryngitis, throat oedema (63.6%), secretions blocking upper respiratory tract (63.6%), tougue falling down (36.3%),pharyngeal cavity contracted(36.3%),oedema and hematoma of soft tissue around respiratory tract(54.5%).Conclusions There are many factors which can cause upper respiratoy tract obstruction after maxillofacial operation. According to the defferent operation, we should take suitable body position and suitable band skill, clear the respiratory tract secretions promptly and take artificial airway wetting. These are the efficient measures of keeping upper respiratory tract unobstructed.