改良喉裂开术
【摘要】目的减少喉裂开术的损伤,减轻患者的痛苦,满足患者的美容要求。方法选择喉裂开手术适应证的患者16例,局麻后环甲膜处正中沿皮纹横切开至双侧胸锁乳突肌前缘,分离带状肌、暴露环甲膜、切开环甲膜置入气管插管行全麻,以后按裂开术式手术,手术结束后于环甲膜置入8 mm气管套管,不再行气管切开。观察术后2 d患者呼吸情况及术后6~12个月术区及环甲膜处的黏膜情况。结果16例手术患者于术后2 d拔除气管套管、缝合伤口、无呼吸困难。6个月至12个月行电子喉镜检查、术区及环甲膜光滑,外观颈部切开缝合处不明显。结论单一横切口行喉裂开术。减少了对患者的损伤和痛苦,有满足了患者的美容需求。【关键词】
喉裂开术;改良
【Abstract】ObjectiveTo reduce the impairment and the pain of the patients after the laryngofission and make the outlook of the cervical part more concinnous through the modifid laryngofission.MethodsFirst,we selected 16 patients who had indications of laryngofission.Second,we made the transversal incision along the dermal ridge of cervical part from the center of the cricothyroid membrane to the anterior border of both sternocleidomastoids,divided strap muscles,exposed and incided cricothyroid membrane in local anesthesia,then performed the general anesthesia by tracheal intubation instead of tracheotomy.Third,we operated on the patient as the laryngofission,we inserted the trachea cannula with the diametre of 8 mm into the incision of cricothyroid membrane when the surgery was over.Fianally,we observed the state of respiration during two days and whether cricothyroid membrane was injured or not during 6 to 12 months postoperationally.ResultsThe dyspnea wasn’t occurred in 16 patients during 2 days and we observed that the mucous membrane of the operative region and cricothyroid membrane was smooth through electronic-laryngoscope and the incision didn’t attract more attention during 6 to 12 months postoperationally.ConclusionThe modifid laryngofission maybe reduce the impairment and the pain of patients and make the operative incision more concinnous. ......
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