Folomeev V N, Ezhova E G
Anesteziol Reanimatol. 1999 May-Jun(3):25-7.
Experience gained in the diagnosis and treatment of 498 patients with postintubation laryngotracheal stenosis is summarized. Use of accessory methods of diagnosis, such as x-ray tomography of the trachea and mediastinum and endofibroscopy of the larynx and trachea is validated. Flexible endoscopes with kits of special instruments allow decannulation without subsequent therapy in 95% patients. Simultaneous tracheoplasty and retracheostomy simplify surgical treatment of patients with postintubation laryngotracheal stenosis, making it shorter by 1-2 stages. The development of laryngotracheal stenoses depends on the duration of intubation, and hence, the optimal term for tracheostomy in patients on forced ventilation of the lungs is day 3 after intubation.
总结了498例气管插管后喉气管狭窄患者的诊断和治疗经验。验证了气管和纵隔X线断层扫描、喉和气管纤维内镜检查等辅助诊断方法的应用。配备特殊器械套件的软性内镜可使95%的患者无需后续治疗即可拔管。同期气管成形术和再次气管造口术简化了气管插管后喉气管狭窄患者的手术治疗,使手术缩短1 - 2个阶段。喉气管狭窄的发生发展取决于插管时间,因此,对于肺部强制通气患者,气管造口的最佳时机是插管后第3天。