论文部分内容阅读
目的 :观察分析喉外伤的临床诊治特点及预后。方法 :回顾性分析 6 0例喉外伤 (其中闭合性 45例 ,开放性15例 )诊治的临床资料。结果 :41例轻中度喉外伤患者 ,在严密监护生命体征的前题下 ,采用保守治疗 ,38例治愈 ,3例声嘶 ;4例重症闭合性喉外伤患者 ,喉梗阻症状明显 ,行气管切开术 ,痊愈出院。 4例轻度开放性喉外伤患者 ,在观察生命体征的前题下行保守治疗 ,痊愈 ;11例重症开放性喉外伤患者喉梗阻症状明显 ,并有喉腔内出血、误吸现象及皮下气肿 ,行紧急气管切开术 ,并根据喉镜纤维气管镜及 CT检查结果行喉裂开喉软骨复位固定 ,粘膜对位缝合 ,对粘膜缺损较多软骨脱位脱落者植入喉膜及 T型硅胶管 ,术后 10 d～ 30 d拔出硅胶管及喉膜 ,0 .5 a～ 1a以上随访 ,1例痊愈 ,9例轻度声嘶 ,1例喉狭窄。结论 :轻度喉外伤可在严密观察呼吸的前题下 ,行保守治疗 ;重症喉外伤如喉梗阻明显 ,应及时行气管切开术。对于重症开放性喉外伤 ,除及早行气管切开术外 ,还应根据 CT片检查结果喉裂开喉成形术 ,如软骨粘膜明显脱位缺损 ,应行喉膜及硅胶管的植入 ,防止喉狭窄
Objective: To observe and analyze the clinical diagnosis and treatment of laryngeal trauma and its prognosis. Methods: The clinical data of 60 cases of laryngeal trauma (including 45 cases closed and 15 cases open) were retrospectively analyzed. Results: 41 cases of mild to moderate laryngeal trauma in patients with strict monitoring of vital signs before the issue of conservative treatment, 38 cases of cure, 3 cases of hoarseness; 4 cases of severe closed laryngeal trauma, laryngeal obstruction symptoms were obvious tracheal Incision, cured and discharged. In 4 patients with mild open laryngeal trauma, conservative treatment was performed under the observation of vital signs, and laryngeal obstruction was obvious in 11 patients with severe open laryngeal trauma and had throat bleeding, aspiration and subcutaneous emphysema, Line emergency tracheotomy and laryngoscope fiberoptic bronchoscopy and CT examination of the throat cleft throat laryngeal cartilage reduction and fixation, mucosal paraposition suture, mucosal defects more cartilage dislocation shedded laryngeal and T-type silicone tube The silicone tube and the laryngeal were removed 10 days to 30 days after operation. The patients were followed up from 0.5 a to 1 years. One case was cured, the other 9 cases had mild hoarseness, and one case had laryngeal stricture. Conclusions: Mild throat trauma can be treated conservatively under the strict observation of respiration. Severe laryngeal trauma such as laryngeal obstruction should be promptly performed by tracheotomy. For severe open laryngeal trauma, in addition to early tracheotomy, CT examination should also be based on the results of throat rupture laryngectomy, such as cartilage mucosa obvious dislocation defects should be laryngeal and silicone tube implantation, to prevent throat narrow