Weiller-Racamier J, Juniot A, Morizot B, Romanet P
Département d'Anesthésie-Réanimation, Centre Hospitalier Régional et Universitaire, Dijon.
Agressologie. 1991;32(1):65-76.
The otorhinolaryngologic (O.R.L.) diseases seen in the emergency room are frequent and diverse. Most of them need the otorhinolaryngologist and anaesthetist to be present in order to realise fast, adequate and, above all, well coordinated gestures. The foreign bodies, the hemorrhagies, the traumas, the infectious diseases and finally the respiratory distress can be classified by frequency order. The laryngo tracheal dyspneas (DL) are first considered because they are the most dramatic emergencies: infectious DL in children, DL secondary to tracheal intubation or tracheotomy, DL caused by a tumor, traumatic DL secondary to a knock, a blast, a burn or a thyroidectomy, edematous DL and "DL after tracheotomy". The infectious O.R.L. emergencies are observed in the serious pharyngeal diseases, in the cervical cellulitis and during the complications of sinusitis or mastoiditis. The foreign bodies (CE) are the most frequent cause of O.R.L emergencies. The complications depends of the location of the foreign: almost nonexistent if the CE is located in the nasal fossa or in the meatus acusticus externus, inconstant if CE is oropharyngeal or oesophageal. The complications may be fatal if CE is pharyngotracheal and are relevant to the exact location of CE which result in emergency behavior. The considered oesophageous lesions not due to CE are chemical burns and perforations; in emergency, hemorrhagic O.R.L. lesions only epistaxias are concerned; O.R.L. hemorrhage need to be studied with their specific causes.
急诊室中常见的耳鼻喉科疾病种类繁多。其中大多数疾病需要耳鼻喉科医生和麻醉师共同在场,以便迅速、充分且最重要的是协调良好地开展治疗。异物、出血、创伤、传染病以及最终的呼吸窘迫可按发生频率排序分类。喉气管呼吸困难(DL)首先受到关注,因为它们是最危急的急症:儿童感染性DL、气管插管或气管切开术后继发的DL、肿瘤引起的DL、撞击、爆炸、烧伤或甲状腺切除术后继发的创伤性DL、水肿性DL以及“气管切开术后DL”。严重的咽部疾病、颈部蜂窝织炎以及鼻窦炎或乳突炎并发症期间会出现感染性耳鼻喉科急症。异物(CE)是耳鼻喉科急症最常见的原因。并发症取决于异物的位置:如果CE位于鼻窝或外耳道,并发症几乎不存在;如果CE位于口咽或食管,并发症则不常见。如果CE位于咽气管,并发症可能致命,且与CE的确切位置相关,这会导致采取紧急措施。所考虑的非CE引起的食管病变为化学灼伤和穿孔;在急诊中,耳鼻喉科出血性病变仅涉及鼻出血;耳鼻喉科出血需要根据其特定病因进行研究。