Hessan H, Houck J, Harvey H
Department of Surgery, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
Laryngoscope. 1988 Feb;98(2):176-80. doi: 10.1288/00005537-198802000-00011.
Involvement of the larynx and trachea by lymphoma is an uncommon problem that can cause life-threatening airway obstruction. High grade obstruction, involvement of the soft tissue of the neck, and tracheal deviation can make intubation and tracheotomy hazardous, if not impossible. Tracheotomy can be ineffective with obstruction of the distal trachea. The clinical presentation and treatment of eight patients with lymphoma involving the larynx or trachea are presented with emphasis on airway management. Dramatic tumor response with relief of airway symptoms was achieved with a regimen of radiotherapy, chemotherapy, corticosteroids, helium-oxygen mixtures, humidity, and intensive care unit monitoring. Direct airway intervention, including tracheotomy, was usually successfully and safely avoided.
淋巴瘤累及喉和气管是一个罕见问题，可导致危及生命的气道梗阻。严重梗阻、颈部软组织受累以及气管偏移会使插管和气管切开术变得危险，甚至无法进行。气管远端梗阻时气管切开术可能无效。本文介绍了8例淋巴瘤累及喉或气管患者的临床表现及治疗情况，重点是气道管理。通过放疗、化疗、皮质类固醇、氦氧混合气、湿度调节及重症监护病房监测的方案，实现了显著的肿瘤反应并缓解了气道症状。通常成功且安全地避免了包括气管切开术在内的直接气道干预。
