烧伤后颈部瘢痕挛缩颏胸粘连患者实施全麻手术时,经口鼻腔插管始终是一项难题,近年来对插管器械与方法作了一些改进,但仍存在较多困难,对于合并小口畸形或喉头移位者更不易进行操作。我们采用直接在颈部瘢痕上做气管切开的办法用于全麻插管。 一、方法:首先在局麻下行气管切开。切口位于拟切除的瘢痕之上或其边缘,其位置相当于颈正中三、四气管环处(不影响下一步手术),横形切开瘢痕,分离瘢痕下软组织与气管前肌群,寻找到气管后,“T”型切开气管软骨环,显露气孔,将气囊导管插入气管内固定,另一端连于呼吸机,此时可开始实施全麻,进行手术。手术即将结束时,皮瓣或植皮片下端与颈侧皮肤 Burn neck scar contracture patients with chin chest adhesions during general anesthesia surgery, oral and nasal cannulation has always been a problem, in recent years, some of the intubation instruments and methods made some improvements, but there are still more difficulties for the merger of small mouth Deformity or laryngeal displacement is more difficult to operate. We used a direct method of tracheostomy on the neck scar for general anesthesia intubation. First, the method: First, under local anesthesia tracheotomy. The incision is located above or at the edge of the scar to be resected, and its position is equivalent to the position of the third and fourth tracheal ring at the middle of the neck (does not affect the next operation). The transverse incision scar, soft tissue under the scar and the anterior tracheal muscle, find the trachea After the “T” type open tracheal cartilage ring, reveal stomata, the balloon catheter inserted into the trachea, the other end connected to the ventilator, then you can begin the implementation of general anesthesia, surgery. At the end of the operation, the flap or skin graft bottom and neck side of the skin