论文部分内容阅读
目的 :探讨不同病因所致慢性严重误吸患者的最佳手术治疗方式。方法 :对 8例慢性严重误吸患者分别采用 3种手术方式治疗 :①气管切开术 (5例 )、颈气管永久性造瘘术 (1例 ) ,气管套管佩带气囊 ,进食时气囊充气以阻止误吸 ;②会厌瓣缝合术 (即喉口闭锁术 ,1例 ) ;③胃永久性造瘘术 (1例 )。结果 :8例患者均能经口进食 ,食物的性状种类不受限制 ,且未发现吸入性肺炎。其中 5例带气囊者仅在进食后放气时 ,略有轻微刺激性咳嗽 ,1例喉癌行Arslan术式者 ,仍有较轻误吸现象 ,以上 6例患者堵管时均能发声 ,可日常交谈 ;1例采用会厌瓣缝合术患者 ,术后经口进食已完全杜绝误吸现象 ;1例行胃永久性造瘘术者 ,能较好解决进食误吸 ,无胃反流现象。结论 :会厌瓣缝合术 (喉口闭锁术 )、气管切开术 (或颈气管永久性造瘘术 )和胃永久性造瘘术 3种术式 ,均是解决慢性误吸的外科治疗方法 ,可依不同的病因及患者的具体情况选择最佳术式。
Objective: To explore the best surgical treatment of patients with chronic severe aspiration caused by different causes. Methods: Eight kinds of patients with chronic severe aspiration were treated by three kinds of operation methods: ① tracheotomy (5 cases), permanent tracheal fistulation (1 case), tracheal cannula to wear air bags, air bags inflated when eating To prevent aspiration; ② epiglottis flap suture (ie laryngeal atresia, 1 case); ③ gastric permanent ostomy (1 case). Results: All 8 patients were able to eat by mouth. The types of food were not restricted and no aspiration pneumonia was found. Among them, 5 cases with balloon were only slightly irritating cough after deflation, 1 case of laryngeal carcinoma underwent Arslan operation, there was still a slight aspiration phenomenon, and all of the above 6 cases could sound when blocked, 1 case of patients with epiglottis flap suture, postoperative oral intake has completely eliminated the phenomenon of aspiration; 1 case of gastric permanent ostomy who can better solve the intake of aspiration, no gastric reflux. CONCLUSIONS: Three kinds of surgical procedures of epiglottis flap (laryngeal atresia), tracheostomy (or permanent tracheal tube) and gastric permanent ostomy are all surgical treatments for chronic aspiration, According to different causes and the specific circumstances of patients choose the best surgical procedures.