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目的 研究急性喉气管外伤不同类型及喉气管狭窄在临床中的各种治疗方法。方法 2 5年来收治急性喉气管外伤 38例 ,喉气管外伤后瘢痕狭窄 1 75例 ,共 2 1 3例。 38例急性喉气管外伤中 ,8例闭合性喉腔软组织伤或合并软骨骨折而无移位 ,采用药物保守治疗 ;1 7例开放性外伤 ,进行清创缝合 ,留置硅胶T型管支撑 ;1 3例闭合性伤 ,喉气管软骨损伤 ,行开放手术复位骨折 ,硅胶T形管支撑治疗。 1 75例喉气管瘢痕狭窄者采用栅栏状喉气管成形术 ;喉气管裂开肋软骨移植术 ;胸舌骨肌瓣移植术 ;复合软骨肌皮瓣成形术 ;摇门式胸舌骨肌皮瓣成形术与复合人工骨肌皮瓣成形术等方法治疗。结果 38例急性喉外伤全部痊愈无后遗症。 1 75例喉气管瘢痕狭窄者 ,4例尚带硅橡胶T型管治疗中 ,3例未治愈 ,1 6 8例治愈 ,拔除气管套管恢复正常呼吸 ,治愈率 96 %。结论 急性喉气管外伤尽早明确诊断 ,早期治疗。喉气管外伤后瘢痕狭窄患者 ,根据狭窄部位和程度采用栅栏状喉气管成形术 ,喉气管裂开自体组织或复合人工骨肌瓣等移植物喉气管成形术 ,效果十分理想。
Objective To study various treatment methods of different types of laryngeal tracheal trauma and laryngotracheal stenosis in clinic. Methods Twenty-five cases of acute laryngotracheal trauma were treated in the past 25 years. There were 231 cases of scar stenosis after laryngotracheal trauma. In 38 cases of acute tracheal trauma, 8 cases of closed soft tissue injury of the larynx or cartilage fracture without displacement, the use of conservative treatment; 17 cases of open trauma, debridement and sutured, placed in silicone T-tube support; 3 cases of closed injury, tracheal cartilage injury, open reduction fracture surgery, silicone T-tube support treatment. 1 75 cases of laryngotracheal scar stenosis with tracheal laryngotracheal surgery; laryngotracheal fractures costal cartilage transplantation; chest x-ray muscle flap transplantation; composite cartilage myocutaneous flap angioplasty; Angioplasty and composite artificial bone myeloplasty and other methods of treatment. Results 38 cases of acute traumatic injury all recovered without sequelae. 1 75 cases of laryngotracheal scar stenosis, 4 cases still with silicone rubber T-tube treatment, 3 cases were not cured, 186 cases were cured, removal of tracheal tube to resume normal breathing, the cure rate was 96%. Conclusion Acute laryngotracheal trauma as soon as possible a clear diagnosis, early treatment. Laryngeal tracheal scar patients with stenosis, according to the site of stenosis and the use of fence-like laryngeal tracheal angioplasty, laryngeal tracheal rupture of autologous tissue or composite artificial bone flap and other graft laryngotracheal surgery, the effect is very satisfactory.