摘要
目的探讨喉烧伤的早期诊治、急性喉梗阻的预防及处理时机和治疗方法选择问题。方法用纤维喉镜对18例喉烧伤患者进行了连续观察,监测喉的各解剖部位的充血、水肿和水泡的发展和运动功能的变化以及对通气功能的影响。结果观察表明,依据呼吸道解剖范围而制定的吸入性损伤的严重程度分类并不能反映喉局部烧伤的严重程度。在镜下根据三个易导致喉梗阻的危险部位的变化:声门裂狭窄、会厌肿胀、喉咽腔内襞的水泡,对喉烧伤的严重程度进行了分析,将喉烧伤分为三型,以指导临床治疗。结论明确吸入性损伤中喉烧伤的诊断,可正确选择治疗方法、确定手术时机,使急性喉梗阻得以缓解,降低吸入性损伤早期死亡率。
Objective To explore early diagnosis and treatment of laryngeal burn,in order to pre- vent laryngeal obstruction,define the prevention of laryngemphraxis,and elect optimal time of treatment and appropriate treatment.Methods A total of 18 patients suffering from laryngeal burn were repeatedly examined with a fiberlaryngoscope.Each part of the larynx was assessed for the degree of congestion, swelling,blister formation and impairment of laryngeal function,and the effects of these pathologies on breathing.Results Our observations showed that classification of inhalation injury according to anatomical division could not reflect the severity of the injury.For this reason,every changes in each part of the larynx was analyzed.A classification consisting of 3 types of larvyngeal injury was proposed in respect to 3 predis- posing factors of laryngeal obstruction.This classification could serve as a guide for treatment.Conclusion A clearcut diagnosis of laryngeal inhalation injury is a pre-requisite for the choice of the correct treatment and the decision on the time for surgical intervention,thus laryngeal obstruction could be avoided,and death rate of early stage of inhalation injury could also be lowered.
关键词
吸入性损伤
喉梗阻
纤维喉镜
诊断
监测
Inhalation injury
Laryngeal obstruction
Fiberlaryngoscope
