闭合性喉气管外伤的诊治

Blunt laryngotracheal trauma:diagnosis and reatment

目的探讨喉气管外伤的诊断和治疗。方法总结分析1985年7月至2004年11月收治的38例患者的临床资料。闭合性喉气管外伤的诊断依据:颈部外伤史和伤后呼吸困难,颈部皮下气肿,声音嘶哑。CT和纤维喉镜检查可以帮助诊断。治疗以紧急气道处理为主,呼吸困难重者应立即行气管切开术。结果11例手术治疗,3例合并颅脑外伤行气管切开,其中1例因脑外伤严重死亡;其余保守治疗,仅6例留有轻度声音嘶哑。结论闭合性喉气管外伤应及时诊断,早期治疗,重者尽早施行手术。

OBJECTIVE To evaluate the diagnosis and treatment of blunt laryngotracheal trauma. METHODS Thirty-eight cases with blunt laryngotracheal trauma were retrospectively analyzed. The most common signs and symptoms were dyspnea,subcutaneous emphysema,hoarseness. CT and flexible fibrolaryngoscopy are suitable for making the diagnosis. Tracheotomy was preferred for airway control. RESULTS Eleven cases were performed and 27 cases were managed with conservative therapy. Thirty seven cases were cured. One case died because brain injury. CONCLUSION Blunt laryngotracheal trauma should be diagnosed and treated as early as possible. The serious cases should be operated on immediately.