【摘要】 目的探讨儿童复杂气管支气管异物取出术中,气管切开并同期行气管切开口缝合的可行性和可能并发症。方法对5例4~6岁复杂气管支气管异物的患儿行气管切开异物取出术。异物分别为塑料笔帽1例、光滑圆柱状塑料串珠2例、光滑金属球1例、光滑陶瓷棒1例。均行保留自主呼吸的静脉麻醉,硬支气管镜下将异物松动并牵拉至声门下,于3~4气管环间横形切开气管,直视下将异物经气管切开处取出。观察呼吸状况至平稳,Ⅰ期缝合气管切开口。结果5例均成功取出异物。气管切开处I期缝合后,均未出现呼吸困难、皮下气肿,术后感染等并发症。随访均1年以上,未出现气管狭窄。结论气管切开取儿童复杂气管支气管异物,同期气管切开口缝合是可行的。轻柔操作和避免多次经声门试取是减轻喉水肿、保持呼吸通畅的关键。更多还原

【Abstract】 Objective To explore a feasible operative method for removal of complicated foreign bodies through a tracheoscope by tracheotomy and sutured tracheostomy.Methods Five patients,aged from 4 to 8 years with complicated airway foreign bodies were subjected to removal operations from March 2004 to July 2007.Foreign bodies included one plastic ball-pen cap,two smooth plastic beads,one steel ball and one smooth ceramic stick.Under general anesthesia,foreign bodies were loosened and pulled to the sub-glottic region.Simultaneously,tracheotomy was performed and the foreign body was extracted by cervical tracheotomy. The trachea was sutured till respiration was safe and steady.Permanent tracheotomy was not necessary.Results All succeeded without complications,such as dyspnea,pneumoderma,and infection.Tracheal stenosis was not found after a 12-month or more period.Conclusion It is feasible to extract complicated airway foreign bodies through a tracheotomy with bronchoscopic control and to suture the trachea instantly after removal of the foreign bodies.The key point of success is to avoid profuse attempts of extraction through the glottis and keep smooth breathing.更多还原