经皮扩张气管切开术在困难气道患者中的应用

李海艳; 翟翔

doi:10.13201/j.issn.1001-1781.2019.10.023

经皮扩张气管切开术在困难气道患者中的应用

李海艳,
翟翔^,

- 天津市环湖医院耳鼻咽喉头颈外科(天津, 300350)

详细信息

通讯作者: 翟翔,E-mail:zhaixiang78@163.com

中图分类号: R767.13

收稿日期: 2019-04-05

Application of percutaneous dilatation tracheotomy in patients with difficult airway

LI Haiyan,
ZHAI Xiang^,

- Department of Otolaryngology Head and Neck Surgery, Tianjin Huanhu Hospital, Tianjin, 300350, China

More Information

Corresponding author: ZHAI Xiang, E-mail: zhaixiang78@163.com

Received Date: 05 April 2019

摘要

摘要: 目的:对困难气道患者进行经皮扩张气管切开术,探讨其在困难气道气管切开术中的应用。方法:回顾性分析行困难气道经皮扩张气管切开术患者的临床资料,总结困难气道患者进行气管切开术的难点及经皮扩张气管切开术的技术要点和优势。结果:收集28例困难气道患者的临床资料,其中头颈部肿瘤手术放化疗后复发者20例,颈部血肿者3例,喉肿物伴心衰者2例,强直性脊柱炎者2例,气道狭窄者1例。气管切开难点为患者无法平躺、颈椎强直、气管移位、应用大剂量抗凝药、颈部组织层次不清等,均行经皮扩张气管切开术(包括经皮旋转扩张及经皮钳式扩张),气管切开术顺利,无并发症发生。结论:经皮扩张气管切开术对于需行气管切开术的困难气道患者是一种安全、快速、微创的手术方法,可作为首选方案。
- 喉梗阻 /
- 困难气道 /
- 经皮扩张气管切开术
Abstract: Objective: To explore the application of percutaneous dilatation tracheotomy for patients with difficult airway. Method: Retrospectively analyzed the clinical data of percutaneous dilatation tracheotomy in difficult airway patients, summarized the difficulties, technical points and advantages. Result: Collecting the clinical data of 28 patients with difficult airway, 20 cases were head and neck tumor recurrence after surgery, radiation and chemotherapy, 3 cases were cervical hematoma, 2 cases were laryngeal neoplasm with heart failure, 2 cases were mandatory spondylitis, and 1 case was airway stenosis. The difficult points for tracheotomy were unable to lie down, neck stiffness, displacement of the trachea, coagulation disorder, unclear neck structure, etc. All patients accepted percutaneous dilatation tracheotomy, including cone and forceps dilatation tracheotomy, with none complication.Conclusion: Percutaneous dilatation tracheotomy was a safe, rapid and minimally invasive surgical method for patients with difficult airway requiring tracheotomy, and could be used as the preferred solution.
- laryngemphraxis /
- difficult airway /
- percutaneous dilatation tracheotomy

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