摘要
目的探讨双侧声带麻痹的病因及手术干预过程中提高治疗效果的手术方法。方法对95例双侧声带麻痹的临床资料进行分析,用电子喉镜检查、术后拔管率及嗓音听主观评估评价声带外移术的手术效果。结果95例双侧声带麻痹的病因中,手术、外伤及插管损伤45例(其中甲状腺手术29例),占47.37%;肿瘤27例,占28.42%,原因不明者11例、占11.58%,颅脑及神经系统疾病与先天性各6例、各占6.32%。手术干预中的17例气管切开术后呼吸困难缓解。12例施行声带外移术的患者,术后1～3个月内全部拔管,无误吸。12例中有11例术后音质变化不明显或仅出现轻度声音嘶哑,仅1例由于术后声门裂过大,出现明显的气息性嘶哑。结论95例双侧声带麻痹的主要病因为手术损伤,其中甲状腺手术占多数。改良Woodman式声带外移术既能解除呼吸困难,不损伤喉腔黏膜,又能保留会话功能,是治疗双侧声带麻痹的理想术式,Ejnell可以作为Woodman式手术失败的补充手术,提高手术成功率。
Objective To detect the etiology of bilateral vocal cord paralysis and the mote effective operalion. Methods Chnical data of 95 cases with endured bilateral vocal cord paralysis were analyzed and the operation effects were assessed by electronic laryngoscope, postoperative extubation ratio and acoustic analysis with subjective auditory assessment. Results Of the 95 cases of bilateral vocal cord paralysis, 45 cases were caused by operation trauma or intubation injure, accounting for 47.37%（involving 29 cases of thyroid operation）, 27 caused by tumor, accounting for 28.42%, 11 cases with unknown reasons, accounting for 11.58%, 6 caused by cranial and neural system diseases and 6 by congenital diseases, accounting for 6.32%,respectively. 17 dyspnea cases relieved after incision of trachea. 12 patients undergoing vocal cord abduction operation were all extubated within 1-3 months without aspiration, 11 of which had no obvious voice quality change or only behaved as mild hoarseness and only 1 of which with over-enlarged glottis vera appeared inhaling hoarseness. Conclusion In these 95 cases of bilateral vocal cord paralysis, the main cause is operation injury,in which thyroid operation accounted for the most part. Modified Woodman operation can not only relieve dyspnea without laryngeal membrane damage, but also maintain the voice function, which is considered as the ideal operation to cure the bilateral vocal cord paralysis. Ejnell operation can be the additional method to increase the operation success ratio.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2008年第6期822-824,共3页
Journal of China Medical University
基金
辽宁省教育厅科技攻关计划项目(05L457)
关键词
声带麻痹
病因
声带外移术
vocal cord paralysis
etiology
vocal cord abduction operation
作者简介
王丽萍（1961-），女，教授，博士．E-mail：wanglp@sj-hospital．org
