碱性腐蚀伤致咽腔狭窄及食管闭锁的食管喉咽腔再造术

本文报告两例吞服碱性液后发生咽腔严重狭窄和食管闭锁患者,经游离空肠移植术治疗后均恢复了吞咽和语言功能。我们在手术中改进了肠咽吻合口,使吻合口扩大,低于喉入口平面,使喉咽腔呈漏斗状,形成一个无底的梨状窝,从而解决了患者吞咽和语言功能等问题。本文讨论了咽喉疤痕挛缩的特点和会厌软骨分流作用的关系。对有意吞服腐蚀剂的患者强调早期分离或扩张,以减轻或避免喉咽腔狭窄。

RECONSTRUCTION FOR HYpOpHARYNGEAL STENOSIS AND ESOPHAGEAL OBLITERATION FROM ALKALINE CHEMICAL BURNS

A successful surgical treatment of two cases of hypopharyngeal stenosis and esophageal obliteration caused by alkaline chemical burns is reported.One patient has recovered respiring,swallowing and speaking functions,and the other also recovered all of these functions except the retained tracheal tube.During the modified jejuno-pharyngostomy,the pharyngojejunal anastomotic stoma was expanded to form a piriform fossa without bottom.Besides,the anastomotic stoma was lowered to the level of laryngeal vestibule so as to prevent food from leaking into the trachea.In the course of clinical observation,we found that different signs existed in different patients who took the corrosive.In the accidental cases,esophageal obliteration often appeared,but in the cases of committing suicide,the obliteration was usually accompanied with hypopharyngeal stenosis,which is very difficult to treat.So the authors emphasize that dilatation and dissection should be undertaken in early stage to prevent the occurrence of hypopharyngeal stenosis.