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环甲膜切开术在严重声门下狭窄患者中的应用——临时非插管气管切开术的优势。

Cricotracheal Resection in a Patient with Severe Subglottic Stenosis - Advantages of a Temporary Non-Cannulated Tracheostomy.

机构信息

Department of Otolaryngology, Medical University of Sofia, Sofia, Bulgaria.

Department of Anesthesiology and Intensive Care, Medical University of Sofia, Sofia, Bulgaria.

出版信息

Balkan Med J. 2017 Apr 5;34(2):165-167. doi: 10.4274/balkanmedj.2016.0108.

Abstract

BACKGROUND

Stenosis in the area of the cricotracheal segment is still a challenging problem to be dealt with. Post-intubational cases mark an increase in recent years due to the advances in intensive care, thoracic surgery and neurosurgery departments.

CASE REPORT

This paper describes a case report of a patient with severe subglottic stenosis (grade III according to the Cotton-Myer scale), introduces a new option in cricotracheal resections - postoperative temporary non-cannulated tracheostomy and describes its advantages.

CONCLUSION

This variation of classical operative techniques provides additional fixation of the trachea, thus relieving any transitory tension on the anastomosis; acts as a valve and decreases the air-pressure in the upper airways during coughing and sneezing in the post-operative period; and is an easy access point for video tracheoscopy of the anastomosis.

摘要

背景

环状软骨气管段区域的狭窄仍然是一个具有挑战性的问题。由于重症监护、胸外科和神经外科的进步,近年来插管后病例有所增加。

病例报告

本文介绍了一例严重的声门下狭窄(根据 Cotton-Myer 分级为 III 级)患者的病例报告,介绍了环状软骨切除术中的一种新选择——术后临时非插管气管造口术,并描述了其优点。

结论

这种经典手术技术的变化提供了气管的额外固定,从而缓解吻合口的任何暂时张力;在术后咳嗽和打喷嚏时充当阀门,降低上呼吸道的气压;并且是吻合口视频气管镜检查的便捷进入点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a358/5394299/a262cc5fe16b/BMJ-34-165-g1.jpg

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