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患者,女,16岁,“魔术”演员,河南商丘人。因走江湖变戏法而到本地。2001年3月20日晚6点30分在表演变戏法时,将10根长4厘米的缝衣针含入口中并做吞下之势,准备将其藏在口中,却不慎将其中一根缝衣针吞下,卡在喉部,当时感喉部剧烈疼痛,呼吸困难。患者用劲呕吐,但症状未见缓解,疼痛加剧。被急送至当地医院诊治,随后转本院急诊。患者在家属的搀扶下勉强坐直后,大夫即检查患者口咽部,未见异物。用间接喉镜检查时,患者已不能叫“依”音,当患者呼气时,见喉部有一缝衣针,针头插在会厌喉面正中,针尾插在左侧室带上。当即向患者口中喷1％丁卡因,但患者马上吐出。只能在无麻醉下叫患者右手拉住舌头,大夫左手拿着间接喉镜,右手拿间接喉钳。嘱患者呼气,当会厌上抬时,用喉钳夹住针头,先将针头脱离会厌喉面,稍往后移,使针头完全纳入喉钳。然后将喉钳上提,顺势将缝衣针完整取出。患者马上感觉喉部疼痛明显减轻,呼吸明显改善。用间接喉镜检查喉部时,患者能叫“依”音,喉部被刺伤处红肿。给予肌注TAT针,静滴青霉素和丁胺卡钠霉素针等抗炎对症治
Patient, female, 16 years old, “magic” actor, Henan Shangqiu people. Because of the juggernaut and went to the local. At 6:30 pm on March 20, 2001, during the performance of the trick, 10 sewing needles, 4 cm long, were swallowed and swallowed, ready to be hidden in their mouths, but accidentally placed one of them Needle swallow, stuck in the throat, throat was severe pain, difficulty breathing. Patients vomited vigorously, but the symptoms have not eased, the pain worsened. Was promptly sent to the local hospital for treatment, then transferred to hospital emergency room. Patient supported by family members barely sit straight, the doctor that check the patient’s oropharyngeal, no foreign body. Indirect laryngoscopy, the patient can not be called “according to” sound, when the patient exhales, see the throat, there is a needle, the needle inserted in the middle of epigastrium throat, the end of the needle inserted in the left ventricular band. Immediately sprayed 1% tetracaine into the patient’s mouth, but the patient immediately spit out. Only in the absence of anesthesia in patients with right hand holding the tongue, the doctor left indirect laryngoscope, indirect throat forceps with his right hand. Zhu Huanzhe exhale, when the epiglottis lift, clamp the needle with a throat forceps, the first needle from the epiglottis larynx, slightly backwards, the needle fully into the laryngeal forceps. Then the laryngeal forceps on the homeopathic needle will be completely removed. Patients immediately felt throat pain was significantly reduced, breathing significantly improved. Indirect laryngoscopy with the larynx, the patient can be called “according to” sound, throat was stabbed redness. Give intramuscular injection of TAT needle, intravenous infusion of penicillin and amikacin needle anti-inflammatory symptomatic treatment