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声带息肉属常见病、多发病,以往多在直接喉镜或联合镜下手术摘除,此法痛苦大,视野不清,术者劳累,病人又难以接受。手术范围也不易掌握。近年来,我科应用间接喉镜下声带息肉摘除术治疗34例,介绍如下: 术前准备 术前4～6h禁食;肌注鲁米那0.1及阿托品0.5mg;向病人解释清楚手术方法,并训练病人拉舌,发“衣”音。 麻醉方法 向口腔及咽喉部喷雾1％地卡因2ml左右,共3次,每次间隔3min左右。病人拉舌,发“衣”音,向喉部喷雾1％地卡因,共3次,每次间隔3min左右。用带弯的喉部麻醉针管吸1％地卡因4～5ml,在间接喉镜下将带弯的麻醉针管伸入喉部将会厌拉开,嘱病人发“衣”音,同时将麻药直接滴入声带,这时麻药分布于声带表面,连续两次。喷雾和直接滴入地卡因总量不超过60mg。
Vocal polyps is a common disease, frequently-occurring disease, in the past mostly in direct laryngoscopy or conjunctival surgery removal, this method painful, blurred vision, the surgeon tired, the patient is difficult to accept. The scope of surgery is not easy to grasp. In recent years, our department under the indirect laryngoscope vocal cord polyp removal of 34 cases, described as follows: preoperative preparation of preoperative 4 ~ 6h fasting; intramuscular injection of 0.1 and atropine 0.5mg; to the patient to explain the surgical methods, And training patients pull tongue, made “clothing” sound. Methods of anesthesia Spray 1% dexamethasone in the mouth and throat about 2ml, a total of 3 times, each interval of about 3min. Patient pull the tongue, made “clothing” sound, throat spray 1% dexamethasine, a total of 3 times, each interval of about 3min. With a curved throat anesthesia needle tube suction 1% tetracaine 4 ~ 5ml, under the indirect laryngoscope will bend the narcotic needle inserted into the throat will be tired open, instruct the patient to send “clothing” sound, at the same time the anesthetic directly Into the vocal cords, then anesthesia distribution in the vocal cords, two consecutive times. The total amount of cocaine sprayed and dropped directly does not exceed 60mg.