摘要
目的探讨经口咽入路齿状突切除手术并发症的防治。方法回顾分析85例经口咽入路齿状突切除手术围手术期的并发症以及预防、治疗措施。结果85例经口咽齿状突磨除手术中,4例出现脑脊液漏,均经腰穿置管持续引流痊愈;1例头皮压伤,3例舌体不同程度压伤,均经对症处理半月后痊愈;2例术前气管切开,2例术后因肺部感染、肺不张行气管切开,另有3例拔管后3～7 d内突发呼吸困难,急救重新气管内插管,加强气管内吸痰,1周内均顺利拔除插管;术后咽部切口均一期愈合;本组无死亡病例。结论脑脊液漏和呼吸道感染仍是经口咽齿状突切除术的最严重并发症,但只要发现及时,治疗正确,这些并发症是可以治愈的;经口咽入路齿状突切除术是安全可行的。
Objective To summarize the experience on the prevention and treatment of complications in odontoidectomy through transoropharyngeal approach. Methods The various complications in 85 patients who underwent odontoidectomy through transoropharyngeal approach, and our methods of prevention and treatment were summarized and analyzed retrospectively. Result Of 85 patients with odontoidectomy, 4 were found cerebrospinal fluid leakage occurred and healed after subarachnoid lumbar drain, pressure injury of scalp in 1 and tongue in 3, and recovered in two weeks, traeheotomies were performed in 2 cases before and after operation respectively, another 3 patients underwent emergent endotracheal reintubation on 3 to 7 clays after operation because of dyspnea caused by pulmonary infection. After one week＇s endotracheal expectoration, all of them were extubated successfully. All the pharyngeal incisions had primary healing, and no death oecured. Conclusions CSF leak and respiratory infection are still the most hazardous complications of transoropharyngeal odontoidectomy, and these complications could be cured by prompt finding and correct treatment. The transoropharyngeal operation would be safe and viable.
出处
《临床神经外科杂志》
CAS
2009年第3期127-129,共3页
Journal of Clinical Neurosurgery
关键词
经口咽入路
齿状突切除术
并发症
transoropharyngeal approach
odontoidectomy
complications
