喉气管狭窄的手术治疗

doi:10.6040/j.issn.1673-3770.0.2016.433

摘要/Abstract

摘要： 目的探讨喉气管狭窄的手术方法及疗效。方法回顾分析山东省千佛山医院耳鼻咽喉头颈外科2009至2015年16例喉气管狭窄手术的临床资料,其中3例喉气管钝性挫伤、1例喉乳头状瘤术后反复狭窄、1例喉癌术后肉芽生成分别实施支撑喉镜下CO₂激光切除术。1例喉癌术后气管内鳞癌、多形性腺瘤及气管腺样囊性癌在鼻内镜下行切除术。1例长时间气管内插管致气管狭窄及1例气管囊腺癌者行气管袖状切除断端吻合术。1例气管腺样囊性癌、2例甲状腺癌及1例气管外伤后狭窄行喉气管重建术。1例食管癌晚期致喉狭窄及1例喉气管外伤老年患者行镍钛记忆合金支架植入术。结果随访12~24个月,除2例外,其余患者均手术后拔管。其中1例喉气管重建术放置T形管后肉芽再次生长;另1例镍钛记忆合金支架植入术后出现排异反应,取出支架,此2例均无法拔管,自动出院后失访。结论喉气管狭窄的手术治疗应根据狭窄的位置及程度选择不同的手术方法,可获得良好的效果。

关键词: 声门下, 外科手术, 气管狭窄, 喉狭窄

Abstract: Objective To explore the operation method and curative effect of laryngeal tracheal stenosis. Methods A retrospective analysis of 16 cases of laryngotracheal stenosis surgery hospitalized in 2009-2015 in the department of otorhinolaryngology, Qianfoshan Hospital of Shandong Province, including 3 cases of laryngotracheal blunt contusion, 1 case of laryngeal papilloma recurrent postoperative stenosis and 1 case of laryngeal cancer following resection of granulation formation were implemented to support CO₂ laser under laryngoscopy. 1 case of laryngeal squamous cell carcinoma, 1 case of adenoid cystic adenoma and 1 case of adenoid cystic carcinoma of the trachea were removed under nasal endoscopy. 1 case of long time endotracheal intubation tracheal stenosis and 1 case of cystadenocarcinoma received tracheal sleeve resection of trachea anastomosis. 1 case of tracheal adenoid cystic carcinoma, 2 cases of thyroid carcinoma and 1 case of tracheal trauma were performed laryngotracheal reconstruction. 1 case of esophageal cancer with advanced laryngeal stenosis and 1 case of laryngeal and tracheal trauma in elderly patient were performed nickel titanium memory alloy stent implantation. Results All were followed up in a duration of 12 -24 months. Except that 2 cases were unable to successfully extubated and were lost after discharge, of which 1 case of laryngotracheal reconstruction placed T tube had still granulation growth and 1 case of nitinol stent implantation after rejection was removed the stent, others were successfully extubated. Conclusion The surgical treatment on laryngotracheal stenosis can obtain good results according to the narrow position and degree.

Key words: Laryngeal stenosis, Tracheal stenosis, Surgical procedures, operative, Subglottic

中图分类号:

R739.65

张生军,王启荣,梁辉,马启奎. 喉气管狭窄的手术治疗[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 77-82.

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