论文部分内容阅读
患者男,25岁。1988年4月2日入院。气管切开术后3年,不能拔管。三年前因呼吸困难,声嘶,在某院行气管切开术并抗炎治疗,但一直不能堵管。无喉痛,不发烧,不咳。以气管切开术后拔管困难入院。全身检查无明显异常。颈前正中环状软骨以下佩带气管套管,堵管时无声嘶,但憋气,耳、咽正常。双喉室狭窄,左假声带增生肥厚,遮盖部分左声带;双声带轻充血,左侧活动差,声门裂6mm,见声门下狭窄。双鼻腔狭窄,下鼻甲小,上复黑绿痂,不臭,清除后下鼻甲表面粗糙,散在多个粟粒状肉芽,右中鼻甲前部增生稍硬。再追问病史,鼻干、鼻阻、偶尔涕带血已十余年。血常规正常,胸透未见异常。诊断:①气管切开术后拔管
Male patient, 25 years old. April 2, 1988 admission. 3 years after tracheotomy, can not extubation. Three years ago due to dyspnea, hoarseness, tracheotomy in a hospital and anti-inflammatory treatment, but has been unable to plug the tube. No sore throat, no fever, no cough. Tracheotomy extubation difficult admission. No abnormalities in the whole body examination. The middle of the anterior cervical ring wear cartilage tracheal tube, blocking hoarseness, but suffocating, ears, pharyngeal normal. Double throat stenosis, left false vocal fold hyperplasia hypertrophy, covering part of the left vocal cord; double vocal cord hyperemia, left activity is poor, the glottis crack 6mm, see the subglottic stenosis. Double nasal stenosis, inferior turbinate small, on the complex black calluses, not stinky, after removal of the inferior turbinate rough surface, scattered in the number of miliary granulation, the right middle turbinate in front of a little stiffer hyperplasia. Then follow the medical history, dry nose, nasal resistance, and occasionally with blood has more than ten years of blood. Normal blood, no abnormal chest X-ray. Diagnosis: ① extubation after tracheotomy