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头颈癌瘤手术有呼吸道阻塞的危险,尤其当切除范围包括下颌、舌、口底联合颈部解剖时,而切除下颌前部、口底、舌后部时危险性更大,气管切开被认为是维持呼吸道通畅的首选方法,但伴随出现各种并发症,其中肺部感染最常见,尤其对于那些因患口腔部癌症而体弱的患者不利。在本回顾性研究中,作者报道了未常规应用气管切开的51名头颈部癌症患者的处理情况。 病例 挑选1992年～1994年间51名符合本研究标准的患者,他们经过颈清扫术,切除肿瘤并修复,所有双侧颈清扫术者均包括在内。所有患者经过标准的术前检查,同样的麻醉及手术,术后均有至少24h的1对1护理。术后若需要可行肺部理疗,行口腔内手术及修复的患者鼻饲饮食。 结果 在本研究中没有因使用皮瓣修复而出现气道阻塞的情况。3名行气管切开术,其中2名痰液分泌
Head and neck cancer surgery has the risk of airway obstruction, especially when the scope of resection including jaw, tongue, mouth combined with cervical anatomy, and the risk of greater removal of the front of the jaw, mouth floor, tongue back, tracheotomy is considered It is the preferred method to maintain airway patency, but with various complications, lung infections are the most common, especially those who are frail because of cancer in the oral cavity. In this retrospective study, the authors reported the treatment of 51 head and neck cancer patients who did not routinely undergo tracheotomy. Cases Fifty-one patients who met the study criteria were selected from 1992 to 1994. They underwent neck dissection, and the tumors were removed and repaired. All bilateral neck dissections were included. All patients underwent standard preoperative examinations, the same anesthesia and surgery, and at least 24 hours of 1-on-1 care. After surgery if possible need for pulmonary physiotherapy, oral surgery and repair of patients with nasal feeding. Results No airway obstruction occurred due to flap repair in this study. 3 tracheotomy operations, of which 2 were secreted by sputum