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山东大学学报 (医学版) ›› 2020, Vol. 1 ›› Issue (7): 72-76.doi: 10.6040/j.issn.1671-7554.0.2020.0125

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Ⅰ期端端吻合术治疗重度颈段气管狭窄临床分析

郭志华1,赵大庆1,邢园2,王薇1,梁乐平1,杨静1,赵倩倩1   

  1. 1. 空军军医大学附属唐都医院耳鼻咽喉头颈外科, 陕西 西安 710038;2. 西安交通大学附属红会医院耳鼻咽喉-头颈外科, 陕西 西安 710054
  • 出版日期:2020-07-20 发布日期:2020-07-10
  • 通讯作者: 王薇. E-mail:wwei.com@163.com

Single-stage end-to-end anastomosis in the management of severe cervical tracheal stenosis

GUO Zhihua1, ZHAO Daqing1, XING Yuan2, WANG Wei1, LIANG Leping1, YANG Jing1, ZHAO Qianqian1   

  1. 1. Department of Otorhinolaryngology, Head and Neck Surgery, Xian Tangdu Hospital, Air Force Medical University, Xian 710038, Shaanxi, China;
    2. Department of Otorhinolaryngology Head and Neck Surgery, Xian Honghui Hospital, Xian Jiaotong University, Xian 710054, Shaanxi, China
  • Online:2020-07-20 Published:2020-07-10

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摘要： 目的 探讨Ⅰ期气管、环气管部分切除端端吻合术在治疗重度颈段气管狭窄中的有效性、适应证和风险因素。 方法 回顾性分析2015年3月至2019年11月采用Ⅰ期部分气管、环气管切除端端吻合术治疗的重度颈段气管狭窄患者29例。其中男19例,女10例,17~51岁,平均31岁。手术方法包括气管-气管端端吻合(18例)、环气管吻合(9例)和甲状软骨气管吻合(2例)。狭窄程度按照Myer-Cotton法分为Ⅲ度18例,Ⅳ度11例。 结果 狭窄长度1~4 cm,平均2.5 cm。一次性手术成功拔管25例(86%)。术后并发症:皮下气肿1例,再次狭窄4例,吻合口裂1例,暂时性声带麻痹1例。 结论 Ⅰ期端端吻合术是一种有效治疗重度颈段气管狭窄的手术方法,手术成功率高。严格的术前适应证选择和术者经验是手术成功的关键。

关键词: 气管狭窄, 手术, 吻合术, 并发症, 再手术

Abstract: Objective To evaluate the efficacy, indications and risk factors of single-stage end-to-end anastomosis in the treatment of severe cervical tracheal stenosis. Methods A retrospective analysis was performed on 29 patients with severe cervical tracheal stenosis treated with single-stage partial tracheal or cricotracheal resection with primary end-to-end anastomosis during Mar. 2015 and Nov. 2019, including 19 male and 10 female, age ranged from 17 to 51(mean 31)years. Tracheotracheal end-to-end anastomosis was performed in 18 cases, cricotracheal end-to-end anastomosis in 9 cases and thyrotracheal anastomosis in 2 cases. The degree of stenosis was classified according to Myer-Cotton classification as grade Ⅲ in 18 cases and grade Ⅳ in 11 cases. Results Length of stenosis was 1-4 cm(mean 2.5 cm). Successful decannulation was achieved in 25 cases(86%). Postoperative complications included subcutaneous emphysema in 1 case, restenosis in 4 cases, anastomosic dehiscence in 1 case, and temporary unilateralvocal fold palsy in 1 case. Conclusion Single-stage end-to-end anastomosis is safe and effective in the management of advanced cervical tracheal stenosis. Careful preoperative evaluation of indications and operators experiences play the most important roles in achieving a positive outcome.

Key words: Tracheal Stenosis, Surgery, Anastomosis, Complications, Reoperation

中图分类号: 

  • R653
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