1、耳鼻咽喉-头颈外科 12 例住院患者死亡分析?H?1002-0179(2007)04-0723-02?Y?w?-?:?H?12?2?-?Otolaryngology-HeadandNeckSurgeryPatientsClinicallyDead(Reportof12Cases)?,?m?v3,?.?,?d?,?,?iWANGJie,ZHUDan,JIANGZhen-hua,etal.(?Y?I?w?Y?w?-?:?H?,?Y6?621000)(DepartmentofOtolaryngology-HeadandNeckSurgery,MianYangCenterHospital,Sichua
2、n621000,China)6?6?:?:?-?Y?w?:?H?2?,?v?,?6?:?a?11?Y?w?:?H?2?W?n?-?6?:?w?(?d6?n?.?n?T?w?,?l?-?Z?T6/12?2/126?:?H?4?.?.?l?w?(?d?h,?j?-?.?v?U?6?h?:?;?;?w?(?d;?H?;?n?.?n?I?-?R7626?6?6?h?7?AAbstract:Objective:Toinvestigatethecausesofdeathoflaryngo-pharyngealheadandneckpatientshavingsurgery,anditsprevention
3、andrescuemeasures.Methods:Twelvemortatilycasesoftheminthepast11yearswerereviewedandanalyzed.Results:EFB,tracheobronchialforeignbodywereprimariythedeathcause,proportionalmortalityindicatorwas6/12and2/12,respectively.Conclusions:OperationunderextracorporealcirculationwasthekeypointtocureEFBcomplicatin
4、gAEFandcarefulrespiratorytractmanagmentcouldcutdownthedeathfromsuffocation.Keywords:death;esophagealforeignbody;aortesophagealfistula;extracorporealcirculation;tracheobronchialforeignbody(Receiveddate:2007-04-18)?1.?2?-?1?O?2?l?34166/12117%?n?.?n?33622/12015%?f?W?c?14811/12016%?9811/12110%?4?4511/12
5、212%?W?9?p1711/12519%6?2?:?(1957-),?b,?(?,?w?w?966?3,?J?,?I?0?M?n?5?w?,366?6?a?1995?1?9?2005?12?9,11?;?10596?2,?12?,?T011%6?U?x?-?12?2?:?5?,?m?U?2?616?:?5?t?12?:?2,?b10?,?2?;?o?115?,?W?74?,?V?4213?612?:?I,?6?,?n?.?n?2?,?f?W?c?1?,?1?,?4?1?,?W?9?p1?6?5?1?2626?U?12?2,?6?,?I3?T?w?(?d(aortesophagealfistu
6、la,AEF)?W?W?x?,?1?T?.?a?x?o?H?;?3?n?.?n?6?f?W?c?6?W?9?p?V?T?,?I?n?7?.?t2?T?W?;?w?2?;?4?V?T?i?A?636?3116?0?6?T?O?b,?Y?w?:?H?O?E?36?m?1,?a?11?12?,?T011%,?-?1?l?:?6/12,?n?.?n?2/12,?0?1/12,?j?f?6?n?.?n?T?c,?,?(?F?A?6?c?2?T?6?9?,?j?-?.?h6?W?p?i?c?T?A?,?w?)?63126?AEF?W?c?T?g?,?w?(?d?T?a?I?w?6?A?(?J?i?-?W?
7、,?W?c?U?T,?68%,?U?T?21%1,?c?T?l?G?,?9?AEF?T?j?,?AEF?2?h?T0108%?210%2,56?U?4?I?(3?U?T?9?AEF,?T0188%6?.?w?,?100%?2?4,1980?Ctercteko?C?.?l?361982?a?s?i?.?l?i?i?66?x?10?T?6?9?,?(?H?+?.?l?AEF?6F?-?-?T3?C?2?;C?V?W?(?p?;C?y?6C?6C?y?0?-,?.?,C?T?,?;?i?y?C?x,?l?6?2,?n?-?U?3?9?AEF,?V?TC?,?I?3?i?l?w?(?d?,?.?t?(
8、?G?W?x?6?m?f?.?f?i?w?(?d?l?,?w?(?d?3?i?.?2?.?T?,?.?l?;?,?O?3?,?(?A,?L?.?9?AEF?2,?a?A?3?H?.?7,?Z?AEFC?2?H?4?.6?2?v?h?O?7,?9?AEF?2?T?6?,?.?AEF?,?;?S?,?-?6?-?i?.:C?,?A?H?4?,?w?w?(?3?i?O?w?(?d?;C?,?A?H?4?,?1?3?i?O?w?(?d?;C?,?-?i?.,?i?A?H?.?4,?w?(?d,?,?2?y6?W?,?x?327?w?2007,22(4)6?CN51-1356/R:0000AE7:2.1
9、0?W?Z?(?)?6?6?6?6?6?6?6?6?1?b40?P?7?G,?x?G?,?t?,?y?W?-?g?K(?w?(?y?t?d?018?015cm)?.?I?W?x?2?b44?P?9?G,?x2?G?6CT?T?3?T?w?(?y?,?3?i?-?Z?w?(?d?(?w?(?016?017?d?)?.?t?U?(?G?W?x?3?b74?P?4?G,?t?T?W?;?G?W?)?(?)?.?a?);?P?T?d?4?,?t?(?I?)?W?x?(1000mL,?w?(?y?:?015cm)?.?I?W?x?4?b38?+?o?P?W?i?7?G,?t?T?W?,?:?6?,?26
10、cm?0?4?5cm?i?,?O?,?8?-?,?(?c?y?W?-?.?t?U?G?i?W?a?(?d,?i?)?5?b56?P?C?7?G,?x2?G?6CT?T?3?T?w?(?y?,?3?i?-?Z?w?(?d?(?w?(?015?014cm?d?)?.?t?U?G?W?x?6?b63?P?9?:?6?x?,?x?;?O?.?o?a?x?7?b115?j?i?i?G?:?6?j?f?.?n?.,?.?t?p?G?j?n?W?j?,?n?7?,?j?y?6?.?t?U?G?C?j?n?W?j?8?215?j?i?i?p?G?:?,?n?;?f?4?.?n?.,?.?t?G?j?n?W?j
11、?9?b46?sS?j?2?G,?:?P?su?t1?o?w?C?10?b58?.?t4?9,?F?t2?9?:?1?96?d?y1?t?i?,?x?,?.?,?O?,?d?O?W,?w?T?O?A?11?b50?4?.?t4?9?:?o?2?G?H?sS?4?T4N1M0su?4?9?v?+?W?O?.6?t?9?p?O?,?A?12?35?2?2?:?l?O?2?n?7?,?G?p(?6cm)6?.?t?U2?G?,?j?n?W?j?C?i?T?w;?-?)?4?,?(?i?6?g?K6?f?.?C?i,?i?O?.,?(?2?w?9?H?)6?H?d?2?7?A?AEF?6?H?O?;?
12、6?G6?;?x?,?3?n?v?.?G?,?A?F?1?,?m?:?,?+?x?i?6?A?w?(?4?G?.?,?(?7?x?,?A?x?V?H?s?x?,?b?0?(?,?.?l?6?)?.?o?6?-?v?,?.?+?-?7,?.,?M?i?f?63136?j?-?.?v?U?6?w?n?t,?W?c?9?(?j?i?,?i?,?t,?j?-?c(?t?W?A?),?Z?.?n?7?t?B?-?c6?n?B?U?m?o,?m?n?m?o,?y?i?/?,?6?,?B?n?7?-?6?(?B?j)6?(?6?2?e?n?)6?w?A?n?.?n?B?4?w?1?B?c?W?(?.?.?I
13、),?(?.?t)6?5?U?C?j?T?,?3?6?0?-6?w?A?.?n?.?I?,?sS?Y6?6?6?su,?B?.?t?6?o?B?m?n?,?0?T?t?F,?8?w?.?f?z?y?c?(?2?-?s?A?)6?l?f?W?c?(?,?7?H,?n?7?.?7,?A?j?t?F?v?(?(?w?T?),?m?E?m?6?n?7?.646?1?h:1?)?,?G?.?A?Y?w?M.?S?.?F,1998:853-854.2NandiP,OngGB.Foreignbodyintheesophagus:reviewof2394caseJ.BrJSurg,1978,65:5-6.3C
14、terctekoG,MorkCK.Aort-esophagealfistulainducedbyaforeignbodyJ.JThoracCardiovaseSurg,1980,80:233-234.4?S?.?w?(?dJ.?I?Y?w?8?,1992,27:91-92.5?2?,?,?m?.?w?(?dJ.?w?,1984,4:31-32.6?s?i?,?,?9,?.?w?(?dJ.?I?w?8?,8,633?s?,?s?,?w?(?d?H?I?H?8?,6,366(?;?B?i8)427WESTCHINAMEDICALJOURNAL2007,Vo1122,No146?CN51-1356/R1922:00-01.7.
