颈部巨大肿块致气管狭窄患者的气管导管型号探讨

The Discussion of Endotracheal Tube Sizes for Patients with Airway Stenosis because of Large Neck Mass

目的:总结颈部巨大肿块致气管狭窄患者的合适气管导管型号。方法:回顾性分析本院2010年7月-2016年8月择期在全身麻醉下行颈部巨大肿块切除术患者10例,记录CT测量的气管最狭窄内径值及患者相应采用的气管导管内径,总结患者的合适气管导管型号。结果:10例患者最窄内径为4.0~6.9 mm,均在纤维支气管镜引导下成功置入内径为6.0~7.5 mm的加强型气管导管,其中经口8例,经鼻2例。9例是一次插管成功,1例是两次插管成功。除了2例患者术后送ICU作进一步治疗外,其余8例患者均在手术室内顺利拔出气管导管。术后随访患者,均未发现有声音嘶哑、咽喉疼痛等相关并发症。结论:颈部巨大肿块致气管狭窄患者的合适气管导管内径可比受压迫气管最狭窄内径大1.5~2.5 mm。

Objective： To summarize the suitable tube size for patients with airway stenosis because of large neck mass.Method： From July 2010 to August 2016% the suitable tube sizes for 10 patients treated in our hospital with airway stenosis because of large neck mass were retrospectively analyzed.The internal diameter about the most narrow part of trachea by CT and the internal diameter of patients＇ endotracheal tubes were recorded.Result： 10 patients＇s internal diameter about the most narrow part of trachea was 4.0-6.9 mm, all the enhanced endotracheal tube guided by the fiber bronchoscope were intubated successfully, sizes were 6.0-7.5 ram, among whom 8 patients by oral, 2 patients by nose. 9 patients succeeded at first time, 1 patients succeeded at second time. 2 patients were treated into ICU for further treatment after operation, other 8 patients all pull out endotracheal tube in operation room.In post-operation follow-up, none of patient had complication like hoarseness and pharyngalgia. Conclusion： The suitable tube size for patients with airway stenosis because of large neck mass is internal diameter larger than the most narrow part of trachea 1.5-2.5 mm.