气管插管后喉损伤17例

目的提高对气管内插管并发喉损伤的认识。方法回顾性分析了对17例气管插管喉损伤的病例,其中环杓关节脱位7例,全部行关节拨动复位术;8例为声带肉芽肿,其中非手术治疗5例,喉显微手术4例(其中1例为非手术治疗无效病例);2例为喉神经麻痹。结果环杓关节复位成功(杓部对称,声嘶改善)5例,失败2例;声带肉芽肿经非手术治疗痊愈3例,无效2例;手术治疗4例,复发3例。结论环杓关节脱位的首选治疗方法是关节拨动复位,复位越早效果越好。声带肉芽肿为难治性疾病,较小声带肉芽肿首选非手术治疗,抗胃食管反流治疗起重大作用;较大肉芽肿选择外科手术治疗,但复发率高。

Injury of Larynx after Endotracheal Intubation: a Analysis of 17 Cases

Objective To improve the knowledge of laryngeal injury caused by endotracheal intubation. Methods Seventeen cases of laryngeal injury caused by endotracheal intubation were retrospectively analyzed.Results Seven patientss suffered from cricoarytenoid joint dislocation and were performed closed reduction. Eight patients suffered from granuloma of vocal cord (five were treated successfully with nonoperative therapy except one who then turned to operation together with the other three ones). Two patients suffered from laryngeal nerve paralysis. Conclusion The first-choice treatment of cricoarytenoid joint dislocation is closed reduction, and early reduction is considered as a better approach. The granuloma of vocal cord is refractory and nonoperative therapy acts as the first choice for the smaller granuloma.