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婴幼儿急性炎性喉狭窄非代偿期气管切开后常发生拔管困难,其原因有长期戴管、手术操作差错、套管选择不合适、术后处理不当、急性喉气管炎遗留症状及拔管恐惧等。作者考虑到儿童的全身状况、气管喉呼吸腔隙狭窄的程度、喉神经肌肉装置的功能状态以及息儿的精神状态,成功地采用了阶段拔管法,由气管套管呼吸逐渐过渡到经鼻呼吸。该法可分以下四个阶段:第一阶段:综合治疗喉气管炎及其并发症。根据儿童年龄和体格状态选择合适的气管套管。管径不大于气管腔隙的2/3,可部分地经自然通道呼吸,哭泣和咳嗽时有响亮的声音为其指征。术
Infants and young children with acute inflammatory laryngeal stenosis tracheotomy often occurs after extubation difficulties due to long-term wear tube, surgical errors, improper choice of cannula, improper postoperative treatment, the symptoms of acute laryngotracheitis and Extubation fear and so on. In view of the general condition of the child, the degree of respiratory larynx stenosis in the trachea and larynx, the functional status of the laryngeal neuromuscular device and the mental state of the infants, the authors successfully adopted the stage extubation method, which gradually transited from the tracheal tube to the nasal cavity Breathe. The law can be divided into the following four stages: The first stage: the comprehensive treatment of laryngotracheitis and its complications. Choose the right tracheal tube based on the child’s age and physical state. The diameter is not greater than 2/3 of the tracheal cavity, which can be partially breathed through the natural channel, with loud sounds when crying and coughing. Surgery