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气管插管后的喉损伤与声音嘶哑。

Laryngeal injury and dysphonia after endotracheal intubation.

机构信息

Department of Otolaryngology, Al-Salam Teaching Hospital, Mosul, Iraq.

Department of Surgery, College of Medicine, University of Mosul, Mosul, Iraq.

出版信息

J Med Life. 2021 May-Jun;14(3):355-360. doi: 10.25122/jml-2020-0148.

Abstract

We carried out a prospective case series study in order to evaluate the laryngeal complications of the endotracheal tube. Two hundred patients aged 15 years and above who were subjected to endotracheal intubation for less than 5 hours were enrolled in the study. The data were collected from the Al-Salam Teaching Hospital in Mosul, Iraq. A preoperative assessment was accomplished clinically using 70º and/or 90º Hopkins rods or fiber optic laryngoscopy. As part of the assessment, the patients' voices were recorded as well. Five to seven days after the procedure, the same assessment was repeated and compared to the preoperative data. If the postoperative examination and the voices were similar to the preoperative data, no follow-up was performed. If any abnormality was found in the larynx, the examination was repeated once weekly for one month or until the voice was recovered. In our study, five patients (2.5%) had intubation-related laryngeal injuries. The intubation period, changes in the position of the head or body of the patient during anesthesia, and the difficulty of intubation raised the possibility of laryngeal injuries. In general, intubation is a safe procedure; however, a laryngeal injury may appear as a rare complication. We found that there is a relation between the intubation period, changing the position of the patient during intubation, and difficulty of intubation with the occurrence of laryngeal injury.

摘要

我们进行了一项前瞻性病例系列研究,以评估气管内导管的喉部并发症。这项研究纳入了 200 名年龄在 15 岁及以上、接受气管内插管时间少于 5 小时的患者。数据来自伊拉克摩苏尔的 Al-Salam 教学医院。术前评估通过使用 70°和/或 90°Hopkins 棒或纤维光学喉镜进行临床检查。作为评估的一部分,还记录了患者的声音。术后 5 至 7 天,重复进行相同的评估并与术前数据进行比较。如果术后检查和声音与术前数据相似,则无需进行随访。如果发现喉部有任何异常,将在接下来的一个月内每周重复检查一次,直到声音恢复正常。在我们的研究中,有 5 名患者(2.5%)发生了与插管相关的喉损伤。插管时间、麻醉期间患者头部或身体位置的变化以及插管的难度增加了发生喉损伤的可能性。总的来说,插管是一种安全的操作,但喉损伤可能是一种罕见的并发症。我们发现,插管时间、插管期间患者位置的变化以及插管的难度与喉损伤的发生之间存在一定的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccf4/8321602/7286f3088997/JMedLife-14-355-g001.jpg

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