严重颈部闭合性损伤致喉气管断裂的救治体会(附8例报告)

Diagnosis and treatment of fragmentation of larynx and trachea

从1976年12月到1996年9月,我们救治了8例严重闭合性损伤致喉气管断裂的患者,男6例,女2例,年龄13～36岁,平均24岁。结果2例死亡,1例死于出血窒息,另1例尚未来得及手术而死亡;1例因救治不当发生喉气管狭窄而需进一步整复,其余5例恢复了喉的功能。强调在修复术中应最大限度地保留破碎的软骨膜、软骨和粘膜。本文重点讨论严重颈部闭合性损伤致喉气管断裂的发病机理、临床特点及急救原则。

Eight cases of fragmentation of larynx and trachea complicated by severe neck closed injury were treated in our department from Dec. 1976 to Sept. 1996. There were 6 males and 2 females, ranging in age from 13 to 36 years. Of the 8 cases, 2 died (one died of bleeding asphyxia, another died before operation), one had laryngotracheal stenosis which required further repair. The reason for the stenosis was thought to be the inadequate first aid management. The other 5 cases restored good laryngeal and tracheal functions. The importance to reserve the damaged perichondrium, cartilage and mucosa as much as posible for the reconstruction of the larynx and trachea was emphasized'. The pathogenesis, clinical feature, diagnosis, and principles of treatment of laryngotracheal trauma were discussed.