经间接喉镜和直接喉镜杓状软骨拨动术的比较研究

A comparison of the closed reduction of arytenoid dislocation under indirect and direct laryngoscope

目的 :探讨在局麻下经间接喉镜和直接喉镜杓状软骨拨动术对气管插管致环杓关节脱位的疗效。方法 :将 2 3例气管插管致环杓关节脱位患者随机安排在局麻下经间接喉镜或直接喉镜行杓状软骨拨动术 ,并对两组进行比较。结果 :每组患者的治疗起始时间与发音功能康复时间呈正相关 ;两组患者的治疗起始时间和发音功能康复时间的比较差异无显著性意义 (P >0 .0 5 ) ,复位次数差异有显著性意义 (P <0 .0 5 ) ,术后咽喉疼痛反应持续时间的差异无显著性意义 (P >0 .0 5 )。结论 :喉损伤的治疗起始时间对患者完全恢复发音功能有重要影响。两种方式对环杓关节脱位均有良好疗效。

Objective:To assess the curative effects of the dislocation of cricoarytenoid joint caused by intubation, indirect laryngoscope (IL) and direct laryngoscope (DL) were utilized to the closed reduction of the displaced arytenoid under local anesthesia.Method: 23 patients who underwent the reduction for dislocated arytenoid by IL or DL from Jan 1991 to Jun 2001 have been reviewed, the records were made as follows: The duration of the laryngeal injury; The number of times for the reduction; The side effective following the treatment; The period of complete return of normal voice. The relation between the duration of the laryngeal lesion and the period of the voice rehabilitation has been studied.Result: 13 patients and 10 patients were respectively arranged to perform the reduction by IL and DL. Except that a comparision on the times of the reduction is significantly different , the difference between IL group and DL group in the course and the period of voice rehabilitation, as well as sore throat after the manipulation are not significant. The patients' voice recovery is positively relative to their course , regardless of IL or DL group.Conclusion:The recovery of normal voice is obviously affected by the duration of arytenoid dislocation. The reduction by IL is as successful as by DL in the treatment of arytenoid dislocation. It is very suitable for the patient having his injury for a longer time to receive the reduction by DL.