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1 病例报告患者,男,40岁。头、面、颈、呼吸道严重火焰烧伤1天入院。检查:头面颈部肿胀,舌体肿大,上腭粘膜及声门区域水肿。入院后第2天出现严重呼吸困难,面色紫绀。拟行紧急气管切开,但患者不能配合,立即行气管插管,由于口腔及上腭粘膜水肿,喉头显露不清,首次试插7.5号气管导管,但误入食管,即将导管留置于食管内。以此管作为引导管,二次试插7.0号气管导管尽量显露会厌,并沿中线对准声门区域使导管顺利通过声门进入气管。此时呼吸道通畅,呼吸困难解除。
1 case report patients, male, 40 years old. Head, face, neck, severe respiratory burn 1 day admission. Check: head and neck swelling, swelling of the tongue, mucosa and glottis area on the palate edema. Severe dyspnea on day 2 after admission and cyanosis. The proposed emergency tracheotomy, but patients can not cooperate immediately tracheal intubation, due to oral and upper palate mucosal edema, laryngeal revealed unclear, the first test tube inserted No. 7.5 tracheal tube, but strayed into the esophagus, the catheter will be placed in the esophagus . Using this tube as the guide tube, the second try insertion of No. 7.0 tracheal tube revealed the epiglottis as far as possible and aligned the glottis area along the midline to allow the catheter to enter the trachea smoothly through the glottis. The airway is clear at this time, breathing difficulties are relieved.