Andrews J C, Mickel R A, Hanson D G, Monahan G P, Ward P H
Laryngoscope. 1987 May;97(5):562-7. doi: 10.1288/00005537-198705000-00005.
The successful use of the tracheoesophageal voice prosthesis for speech rehabilitation of the total laryngectomy patient has lead to common application of this device. Although the creation of a tracheoesophageal fistula is a simple procedure, it is not without complications. A review of 104 patients who underwent this procedure indicated a complication rate of 25%. Complications were related primarily to the fistula and included migration and progressive enlargement of the puncture, persistent or recurring infection of the fistula site, aspiration pneumonia, and death. Other problems included aspiration of the prosthesis, vertebral osteomyelitis, and tracheal stomal and esophageal stenosis. Many of these patients required hospitalization, intravenous antibiotics, and major surgical procedures to treat these complications. Guidelines for early identification and management of these problems as well as methods to prevent complications are discussed.
气管食管语音假体在全喉切除患者言语康复中的成功应用已促使该装置得到广泛应用。尽管气管食管瘘的创建是一个简单的手术，但并非没有并发症。对104例行此手术的患者进行回顾显示，并发症发生率为25%。并发症主要与瘘管有关，包括穿刺部位的移位和逐渐扩大、瘘管部位的持续或反复感染、吸入性肺炎及死亡。其他问题包括假体误吸、椎体骨髓炎以及气管造口和食管狭窄。许多此类患者需要住院治疗、静脉使用抗生素以及进行大型外科手术来治疗这些并发症。本文讨论了这些问题的早期识别和管理指南以及预防并发症的方法。
