AIRWAY COMPLICATIONS IN THYROID-SURGERY
AIRWAY COMPLICATIONS IN THYROID-SURGERY
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DOI：
10.1177/000348949310200607
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发表时间：
1993-06-01
影响因子：
1.4
通讯作者：
FUSCIARDI, J
中科院分区：
文献类型：
--
作者：
LACOSTE, L;MONTAZ, N;FUSCIARDI, J
我们对3,008例甲状腺切除术的围手术期和术后发病率和死亡率进行了研究。胸骨后甲状腺肿和癌性甲状腺肿中常见的压迫性症状出现在11.0%的患者中，尽管观察到呼吸困难的发生率较低（2.7%）。在大的甲状腺肿，一些经口气管插管是困难的。在这种情况下，经气管入路也可能很困难，因此应预期失败。术后呼吸道阻塞的原因包括局部阻塞、双侧返神经麻痹和喉水肿。未观察到气管塌陷。这些呼吸道阻塞导致11名患者再次手术，3名患者气管造口术，1名患者暂时重新插管并接受类固醇治疗。喉返神经，这可能是术前受到影响，被发现在0.5%的良性甲状腺肿患者术后受损，相比之下，10.6%的甲状腺癌患者。在最后一组中，在3例长期或广泛手术的病例中观察到双侧麻痹。在这些短期经口气管插管（平均114分钟）后，4.6%的患者发现气管插管引起的气道损伤。
Perioperative and postoperative morbidity and mortality were studied in a series of 3,008 thyroidectomies. Compressive symptoms, frequent in substernal and cancerous goiters, were present in 11.0% of the patients, although a low rate of dyspnea (2.7%) was observed. In large goiters, some orotracheal intubations were difficult. In such cases, the transtracheal approach can also be difficult, so failure should be anticipated. Postoperative causes of respiratory obstruction included local hemorrhages, bilateral recurrent nerve palsies, and laryngeal edema. A tracheal collapse was not observed. These respiratory obstructions led to repeat surgery in 11 patients, tracheostomy in 3, and temporary reintubation with steroid therapy in 1. The recurrent laryngeal nerve, which may have been affected preoperatively, was found to be damaged postoperatively in 0.5% of the patients with benign goiters, compared to 10.6% of the patients with thyroid cancer. In this last group a bilateral palsy was observed in 3 cases with prolonged or extensive surgery. After these short-term orotracheal intubations (114 minutes on average), injuries of the airway caused by the endotracheal tube were found in 4.6% of the patients.