杓状软骨脱位的病因分析及治疗(1)
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【摘要】 目的 分析杓状软骨脱位的原因及其治疗效果。方法 对33例杓状软骨脱位患者的临床资料进行回顾性分析。结果 33例杓状软骨脱位患者中,气管内插管麻醉史30例(90.91%),插胃管史2例(6.06%),三腔二囊管压迫止血史1例(7.03%)。30例气管插管史的患者中,男26 例(86.67%),女4 例(13.33%);年龄<50岁 10例(33.33%),>50岁20例(66.67%);留管时间最短1 h,最长16 h,平均 5.2 h,气管插管留管时间超过5.2 h有14例(46.67%),<5.2 h有16例(53.33%);21例(70%)全身状况较差,9例(30%)全身状况较好。25例在电子纤维喉镜下行杓状软骨拨动复位术,21例(84%)有效,4例(16%)无效。结论 气管插管是杓状软骨脱位的主要病因,而患者性别、年龄及全身状况是气管插管导致杓状软骨脱位的影响因素,使用表面麻醉在电子纤维喉镜下行杓状软骨拨动复位术,可获良好效果。
【关键词】杓状软骨脱位; 气管插管; 治疗
Analysis of origin and treatment in patients with arytenoid dislocation
HUANG Xue-kun,LIU Hong,LI Peng,et al.Department of Otolaryngology,the Third Affiliated Hospital of Sun Yat-Sun University,Guangdong,Guangzhou,510630,China
【Abstract】 Objective To analyze the origin and treatment in patients with arytenoid dislocation.Methods 33 patients with arytenoid dislocation were analyzed by retrospective.Results Among 33 patients there were 30 cases with the history of endotracheal intubation.Among the 30 cases,male was 86.67%and female was 13.33%,66.67%patients was older than 50 years and 33.33%patients was younger than 50 years.The average time of remain endotracheal intubation was 5.2 hours,46.67%cases was over 5.2 hours and 53.33%was less than 5.2 hours.The general condition of 70%cases was worse and 30%cases was better.After reduction of 25 cases,84%cases waseffect and 16%cases was failed.Conclusion The mainly origin of arytenoid dislocation is endotracheal intubation.The sex;age and general condition of patient are the dangerous factors to arytenoid dislocation after endotracheal intubation.Arytenoid reduction is an effect treatment for arytenoid dislocation.
【Key words】Arytenoid dislocation;Endotracheal intubation;Treatment
DOI:10.3760/cma.j.issn 1673-8799.2010.06.21
作者单位:510630广州,中山大学附属第三医院耳鼻咽喉科
环杓关节脱位包括杓状软骨脱位(arytenoid dislocation)和杓状软骨半脱位(Arytenoid subluxation,AS)。杓状软骨脱位指杓状软骨与环状软骨关节面完全分离,杓状软骨半脱位指杓状软骨与环状软骨关节面的接触异常。目前尚未有明确的客观指标来界定两者的区别。杓状软骨脱位以前脱位和后脱位常见。后脱位表现为杓状软骨向后外移位,患侧声带突偏外且高于对侧。前脱位则表现为杓状软骨向前、内倾斜,声带突位置较低。杓状软骨脱位临床主要表现为声音嘶哑,气息声、吞咽痛、咽喉不适和发声疲劳。杓状软骨脱位常由于喉内损伤引起[1]。本文回顾性分析2004年11月至2009年4月耳鼻喉科收治33例杓状软骨脱位患者的病因和治疗,现报告如下 ......
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