七年制医学课件 耳鼻喉 5喉阻塞

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1、喉阻塞laryngealobstructionlaryngemphraxis（喉梗阻）lesionsoflarynxandneighbortissuseleadtotheobstructionoftheairway(通道)andfinallyresultinthedyspnea（呼吸困难）.narrowness-----obstruction1.Etiology病因学(1)Inflamation炎症(2)Trauma外伤(3)Foreignbody异物(4)Tumor肿瘤(5)Deformity畸形(6)paralysisofvocalcord声带瘫痪（7）Edema水肿2.ClinicalA

2、ppearance临床表现(1)inspiratorydysplasia吸气性呼吸困难(2)inspiratorystrider吸气性喘鸣(3)retractionofthefourconcavesigns四凹征(4)hoarseness声嘶(5)cyanosis（紫绀）吸气期呼吸困难示意图吸气期软组织凹陷3.ExaminationInoinspiratorydysplasiainsilenceIIinspiratorydysplasiainsilencewithouthypoxia（缺氧）IIIinspiratorydisplasiawithhypoxiaIVinspiratorydyspl

3、asiaseriously4.Diagnosiseasytodiaglosis5.differentialdiagnosisinspiratorydysplasia（吸气性呼吸困难）expiratorydisplasia（呼气性呼吸困难）mixeddysplasia（混合性呼吸困难）3种阻塞性呼吸困难鉴别要点6.TreatmentItomaketheoriginaldiseaseclearandtreatitatonce明确病因，积极治疗IIinflamation------enoughantibioticsandhormone药物治疗tumorortraumaparalysisofvocal

4、cord------tracheotomy可行气管切开术IIIinflamation---medicinetreatment药物治疗Prepareforthetracheotomy准备气管切开术--Tumor------tracheotomyatonce立刻气管切开术IVTimeisimportanttracheotomyimmediately气管切开术或环甲膜切开术气管切开术tracheotomy1.切开颈段气管前壁并插入气管套管，使病人直接经套管呼吸的手术，是抢救危重病人的急救手术2.Indication（适应证）(1)larygealobstructionIII~IV(2)lowerre

5、spiraterytractobstructioncomaetc(3)prophylacticsurgery（预防性手术）(4)longtimeassistantrespiration