Perioperative period management of laryngotracheoplasty using anterior cricoid split procedure with free hyoid grafting
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摘要: 目的 总结儿童获得性声门下狭窄行游离舌骨重建环状软骨喉气管成形术围术期的管理要点，为减少术后并发症，提高拔管成功率，促进患儿康复提供参考。方法 纳入2017年9月—2021年6月在上海市儿童医院耳鼻咽喉头颈外科行游离舌骨重建环状软骨喉气管成形术治疗的25例声门下狭窄的患儿，对患儿均实施规范的围术期管理策略。结果 本组患儿成功拔管21例，2例T管换成气管套管后堵管，2例患儿换成气管套管后尚未堵管。结论 游离舌骨重建环状软骨喉气管成形术术后正确实施围术期管理，可以有效降低或控制相关并发症，保持气道通畅，促进喉功能恢复，缩短气管切开患儿带管时间，提高生存质量。Abstract: Objective To review the key points of the perioperative period management of laryngotracheoplasty using free hyoid grafting in children with acquired subglottic stenosis, in order to reduce postoperative complications, to improve extubation rate, and to promote the rehabilitation of the patients.Methods Twenty-five cases with subglottic stenosis were treated by laryngotracheoplasty using free hyoid grafting in department of Otolaryngology, Head and Neck Surgery, Shanghai Children's Hospital from September 2017 to June 2021. Standardized perioperative period management protocols were carried out in all 25 cases.Results 21 cases were successfully extubated, T tubes of 2 cases were replaced by tracheal tubes which have been sealed, but tracheal tubes sealing was failed in 2 cases after tube replacement.Conclusion High quality perioperative period management of laryngotracheoplasty using free hyoid grafting can effectively reduce related complication rate, maintain airway patency, promote laryngeal function recovery, shorten the period of tracheotomy and improve the quality of life.
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表 1 25例患儿临床资料
例序 性别 年龄/月 Cotton分型 T管型号 体重/kg 身高/cm 1 男 25 Ⅳ 8 13 92 2 男 14 Ⅱ 7 11.5 75 3 女 27 Ⅱ 7 9 83 4 男 33 Ⅲ 7 9 81 5 男 14 Ⅳ 7 7.5 73 6 男 11 Ⅱ 7 6 70 7 女 22 Ⅱ 7 12 84 8 女 13 Ⅲ 7 5 65 9 男 27 Ⅱ 7 10 88 10 女 25 Ⅱ 7 11 87 11 男 41 Ⅳ 7 15 95 12 男 24 Ⅲ 8 11 81 13 男 29 Ⅳ 8 12 90 14 男 15 Ⅲ 7 9.5 76 15 女 23 Ⅳ 7 11 85 16 男 13 Ⅲ 7 10 74 17 男 19 Ⅲ 7 10 75 18 女 21 Ⅱ 7 12 72 19 男 22 Ⅳ 7 9.5 79 20 男 24 Ⅲ 7 8 75 21 女 12.5 Ⅳ 7 10 76 22 女 16 Ⅳ 7 9 76 23 男 29 Ⅲ 7 10 79 24 男 19 Ⅱ 7 9 78 25 男 18 Ⅲ 8 10 81 
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[1] 倪鑫, 张天宇. 实用儿童耳鼻咽喉头颈科学[M]. 北京: 人民卫生出版社, 2021: 738-738.
[2] 郭志华, 崔鹏程, 赵大庆, 等. 15例特发性声门下狭窄诊疗分析[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(2): 173-176. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH202002018.htm
[3] 刘晓君, 陈佳瑞, 徐宏鸣, 等. 游离舌骨重建环状软骨治疗获得性声门下狭窄的疗效评估[J]. 中国耳鼻咽喉头颈外科, 2021, 28(1): 10-13. https://www.cnki.com.cn/Article/CJFDTOTAL-EBYT202101003.htm
[4] 王颖, 李晓艳. 儿童喉气管狭窄的研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(21): 1684-1686. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201821019.htm
[5] 王欢, 郭琳燕, 杨晓娜. 综合护理在行T型管置入术的喉气管狭窄患者围术期护理中的应用效果[J]. 临床医学研究与实践, 2021, 6(8): 156-158. https://www.cnki.com.cn/Article/CJFDTOTAL-YLYS202108054.htm
[6] 陶金好, 陆国平. 气道湿化治疗[J]. 中华实用儿科临床杂志, 2018, 33(6): 413-415. doi: 10.3760/cma.j.issn.2095-428X.2018.06.004
[7] 吕丰梅, 吴禹燕, 吴小花. 口腔喷雾对经口吸氧病人气道湿化效果的影响[J]. 护理研究, 2016, 30(35): 4443-4445. doi: 10.3969/j.issn.1009-6493.2016.35.030
[8] 黄静, 王桂兰. 儿童喉气管狭窄重建术围手术期护理体会[J]. 上海护理, 2020, 20(12): 32-35. doi: 10.3969/j.issn.1009-8399.2020.12.007
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