甲状腺手术发生呼吸道机械性梗阻的原因及措施

目的 探讨甲状腺手术发生呼吸困难的原因和应对处理。方法 回顾1998年至2010年10月共行的312例甲状腺手术,分析9例在围手术期发生呼吸困难、窒息的原因和应对处理。结果 围手术期出现呼吸困难症状的8例,窒息1例。根据其发生原因分别行药物雾化吸入、吸氧、切口内血肿清除、气管插管、气管切开等处理,恢复良好,无死亡病例。结论 了解甲状腺围手术期发生呼吸困难的原因,及时准确的判断发生呼吸困难的原因,就近迅速给予相应处理。不能及时准确判断发生呼吸困难的原因或经相应处理后呼吸困难仍无明显缓解,有出现窒息危险的可适当放宽气管切开的指征,优先恢复气道通畅。

Objective To provide the reasons of dyspnoea on the perioperative period of thyroid gland and how to deal with them.Methods 312 cases were followed back,which were operated on thyroid gland from 1998 to october.2010.And 9cases were analysised about the reason and treatment of dyspnoea and asphyxia on perioperative period.Results There were 8 cases of dyspnoea and 1cases of asphyxia on perioperative period.They were treated in different ways based on the different reasons.All the 9 cases recovered well and there was no one case of death.Conclusion Understand the reasons of dyspnoea during the perioperative period of thyroid gland operation,then judge and deal with them in time and exactedly.If timely and exact judgement can＇t be made or dyspnoea can＇t be obviously anesised,indicatio of trachotomy should be properly broaden to rebuild airway firstly.