气管插管后持续性声嘶的原因及其治疗

Causes and treatment of lasting hoarseness after endotracheal intubation

目的 探讨气管插管后持续性声嘶的原因及评估杓状软骨复位术的治疗效果。方法 对７８例病人通过检查及疗效观察，确定声嘶原因。采用杓状软骨复位术及肉芽摘除术治疗。结果７８例中，７１例为杓状软骨脱位（９１．０３％），５例声带麻痹（６．４１％），２例喉内肉芽形成（２．５６％）。构状软骨脱位的病人全部治愈；声带麻痹治疗无效；喉肉芽形成的病人，１例治愈，另１例发音改善。结论 构状软骨脱位、声带麻痹及喉内肉芽形成是气管插管后持续性声嘶的主要原因；构状软骨复位术对构状软骨脱位所致的声嘶疗效明显。

Objective To investigate the causes of lasting hoarseness due to endotracheal intubation and to evaluate the effect of arytenoid reduction. Methods The causes of lasting hoarseness were confirmed by the examination of laryngoscope and the analysis of therapy. Arytenoid reduction and laryngeal granuloma removal were performed in 78 patients. Results Among the 78 patients. 71 showed arytenoid dislocation, 5 exhibited vocal cord paralysis and the other 2 showed granuloma. By treatment, all patients with arytenoid dislocation were cured. One case with granuloma fully recovered, another patient's voice improved. Patients with vocal cord paralysis failed to improve their voice. Conclusion It seems the 3 major causes of lasting hoarseness after endotracheal intubation are arytenoid dislocation, vocal cord paralysis and granuloma in larynx. Arytenoid reduction is a very useful therapy for the hoarseness caused by arytenoid dislocation.