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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。
Objective To investigate the feasibility and possible complications of tracheotomy and tracheotomy in children with complicated tracheobronchial foreign bodies during operation. Methods A total of 5 children aged 4 to 6 years with complicated tracheal bronchial foreign bodies were treated with tracheotomy. Foreign bodies were plastic cap in 1 case, smooth cylindrical plastic beaded in 2 cases, 1 case of smooth metal ball, 1 case of smooth ceramic rod. All patients were given intravenous anesthesia for spontaneous respiration. After hard bronchoscopy, the foreign body was loosened and pulled under the glottis. The trachea was transversely cut off between 3 ~ 4 tracheal rings, and foreign bodies were removed by tracheotomy under direct vision. Observation of respiratory status to stable, Ⅰ suture tracheotomy. Results 5 cases were successfully removed foreign body. Tracheotomy incision I period, no dyspnea, subcutaneous emphysema, postoperative complications such as infection. Follow-up were more than 1 year, there was no tracheal stenosis. Conclusion tracheotomy children complicated tracheobronchial foreign body, the same period of tracheotomy suture is feasible. Gentle manipulation and avoidance of multiple glottis trials are the key to reducing laryngeal edema and keeping your breathing clear.