论文部分内容阅读
1 病例介绍例1:女.33岁.于1986年2月出现四肢关节疼痛,但无红肿.5月鼻中隔粘膜充血肿胀,继之软骨破坏,鼻梁塌陷.9月出现气短,呼吸困难,但无声嘶.1987年l月在某医院行喉气管纤维镜检查:声门下呈环形膜状狭窄,并行喉裂开放置普通塑料管扩张.术后切口长期溃烂不愈,持续发热,故取出扩张管,戴金属套管.此后多次拨管.气管切开放管.1988年4月以喉气管狭窄、气管切开拔管困难1.5年入院.查:心肺(一),鼻软骨部为纤维性收缩,鼻梁塌陷,前鼻孔收缩变小,并呈40°角,鼻中隔软骨缺失,双下甲萎缩,鼻腔有大量干痂.间接喉镜下见会厌披裂正常,声带微充血,活动好.吸气时声门下前壁粘膜向腔内突起,狭窄,培管即出现呼吸困难.颈前甲状软骨水平以下塌陷为瘢痕组织.血沉65mm/h,颈侧位X线片示喉气管狭窄.其它检查均正常.诊断:复发性多软骨炎;①喉气管狭窄;②鞍鼻.
Case description 1: Female .33 years old. In February 1986, there was joint pain in the limbs, but no redness. May mucosal swelling and swelling of the nasal septum, followed by cartilage damage, collapse of the bridge of the nose. September shortness of breath, difficulty breathing, but silent Hiss .1987 l hospital in a laryngotracheal tube examination: subglottic was ring-shaped membranous stenosis, parallel open throat open ordinary plastic tube dilatation.Postoperative incision long-term ulcers, continuous fever, so remove the dilation tube, Wear metal casing .Has repeatedly dial .Endotomy tube .1988 in April laryngeal tracheal stenosis, tracheotomy extubation 1.5 years hospitalized.Check: cardiopulmonary (a), Department of nasal cartilage fibrous contraction, Nasal bridge collapse, the former nostril shrinkage smaller, and was 40 ° angle, missing cartilage in the nasal septum, double inferior atrophy, nasal cavity has a lot of dry scab. Indirect laryngoscopy see epiglottis tear normal, vocal cord micro-hyperemia, good activity. Lower anterior wall mucosa protruding to the cavity, stenosis, breathing difficulties that appear in the trachea .Anterior neck thyroid cartilage collapse below the level of scar tissue .Shui Shen 65mm / h, lateral cervical X-ray film showed laryngeal tracheal stenosis.Other other tests were normal. Diagnosis: recurrent polychondritis; laryngotracheal stricture; saddle nose.