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光导纤维喉镜对于间接喉镜下难于完成的喉部极小良性病变的摘除和有关检查,无不具有独特的优越性.但其对于喉部较大肿块的摘除常常显得无能为力.如果对之贸然手术就有引起突发窒息的危险.我们曾对4例喉部巨大肿块,于纤维喉镜下手术摘除,因术中患者突发窒息,呼吸困难,情况十分危险,后均改行其他方法治愈.现总结其教训,报告如下.1 病例报告例1 男,42岁.因持续性声嘶3年于1991年2月来我科就诊.间接喉镜下见右声带近前联合处有一1.5cm×1.0cm×O.8cm大小、有短蒂之息肉样物.以1%地卡因喉部喷雾数次,患者无不适,平卧后经右鼻腔插入纤维喉镜渐达喉入口,插入21mm息肉钳,对准肿块蒂部钳咬数次.这时.患者突然呛咳一下.整个肿块一下吸到声门下.患者十分难受,突然拔掉纤维喉镜,挣扎起身,继而出现窒息表现,
Optical fiber laryngoscope for the laryngeal difficult to complete under the laryngeal minimal benign lesions removal and related examination, all with unique advantages, but its removal of larger laryngeal often can not help .If the rash surgery We have the risk of sudden suffocation.We have 4 cases of laryngeal huge lumps, under fiber laryngoscope surgery removed due to intraoperative sudden asphyxia, breathing difficulties, the situation is very dangerous, after the switch to other methods of cure. Summarize the lessons learned, the report is as follows .1 cases reported in Example 1 male, 42 years old due to persistent hoarseness 3 years in our hospital in February 1991. Indirect laryngoscopy see the right vocal cord near the joint at a 1.5cm × 1.0cm × O. 8cm in size, a short pedicle of polyp samples to 1% of the number of cocaine laryngeal spray several times, the patient without discomfort, supine after the right nasal cavity inserted into the laryngoscope gradually laryngeal laryngeal entrance, insert 21mm polyp forceps, At this moment, the patient suddenly coughed, and the entire mass was absorbed under the glottis. The patient was very uncomfortable, suddenly pulled out the fiber laryngoscope, struggled to get up, and then appeared asphyxiation,