创伤中耳鼻咽喉-头颈外科的综合救治(附1083例分析)

The otolargngology head and neck surgery compositive remedy for the injuries in daily life:Analysis of 1083 cases

目的 探讨现代创伤的综合救治 ,提高其诊治水平。方法 对随访的 10 83例患者临床资料进行回顾性分析 ,根据疾病不同采用不同的治疗方法。结果 经随访疗效满意。结论 手术导航仪辅助下鼻内镜脑脊液鼻漏修补、深部鼻窦异物取出安全、快捷 ,鼻窦 CT中鼻腔顶、筛顶处细小、悬垂乳头状影为脑脊液鼻漏漏口定位中极其重要又易被忽视的影像学改变 ,脑脊液筛顶漏、筛骨水平板漏区别开对手术有极其重要的意义。自行研制的单手操作、按压式机械 (非电动 )耳鼻咽喉科喷雾器因其明显的优越性应完全取代目前国内普遍应用的双手操作、挤捏式机械喷雾器。喉咽、食管的大角度曲折、多段狭窄者首选带囊导管扩张 ,了解上消化道狭窄部位及程度 ,以消化道内置入带囊导管注入造影剂后的显影较传统食管钡透准确。早期气管切开及有效的血管伤救治是降低死亡率的关键。创伤性传导聋应据病情采用不同的术式。

Objective To investigate compositive approaches of diagnosis and therapy to wounds caused in the modern wars and improve the effects of diagnosis and therapy.Method One thousand and eighty three correlative cases were analyzed retrospectively,different approaches of therapy were adopted according to different kinds of diseases.Result All patients have been followed up,the effect of the therapy was satisfying.Conclusion The remedy for endoscopic cerebrospinal rhinorrhea assisted by operation navigation instrument as well as the extraction of articles from inner sinus is safe and shortcut.In the sinus CT,the tiny mastoid overhanging shadow which locates on the tope of nasal cavity and ethmoid is an extremely important and easily ignored image change in the location for the opening of cerebrospinal rhinorrhea.Its vital for operation to distinguish the cerebrospinal rhinorrohea lied in the ethmoid roof from that loeated in cribriform plate.Because of its evident advantage,the single-hand operated,pressed and mechanical(not electric)sprayer used in the E-N-T deparment should replace the current pervasive dual-hand squeezed one.Bag catheter dilatation is the preferred approach for the patients with many stenosing segments in their laryngopharynx and esophagus which are twisted seriously.To check the exact location and comprehend the extent of upper digestive canal stenosis,comparing with traditional digestive canal barium examination,the method of placing a bag catheter infused with developer into digestive canal to develop image is more accurate.To reduce the death rate,its a sticking point to adopt early tracheotomy and effective remedy of vein wounds.Different operation modes should be adopted for the traumatic conductive hearing loss according to different diseases.