1例全麻插管致杓状软骨脱位的护理及启示

Nursing and Enlightenment of Arytenoid Dislocation 1 Cases Induced by General Anesthesia Intubation

杓状软骨脱位是临床麻醉中较少见的一种并发症,患者会有不同程度的声音嘶哑、进食水呛咳等症状,应当予以重视。分析全麻气管插管致杓状软骨脱位的可能原因,并提出护理对策,脱位原因包括:带胃管的老年患者、高龄、体瘦,保留气管导管时间长,拔气管导管的方法欠佳,掌握拔管时机不妥等因素。笔者认为通过正确的拔管方法,掌握拔管指征,观察患者呼吸发音吞咽状况等护理措施,可以降低因气管插管导致杓状软骨脱位的并发症。我科去年1例肾癌患者行全麻下腹腔镜下肾部分切除术后出现了声音嘶哑,术后第7d确诊为杓状软骨脱位,经过精心护理后好转出院,现报道如下。

Arytenoid dislocation is one of the rare complications in clinical anesthesia,patients have dif erent degree of hoarseness,feeding water choke symptoms such as cough,should at ach importance to it.Analysis of general anesthesia endotracheal intubation induced arytenoid dislocation of the possible reasons,and put forward nursing countermeasures,dislocation reasons include:elderly patients with gastric tube,older age,thin body,keep the endotracheal tube long,pul out the endotracheal tube method,master the decannulation time wrong.The author believes that through the cor ect decannulation method,master the indications,extubation nursing measures such as breathe pronunciation swal ow observe patients condition,can reduce the complications of arytenoid dislocation caused by endotracheal intubation.Our department last line under general anesthesia in a patient with kidney cancer after laparoscopic partial nephrectomy appeared a hoarse,postoperative day 7,diagnosis of arytenoid dislocation were careful y nursing after improved,now report as fol ows.