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我院1989年～1992年手术治疗口腔颌面部癌20例行舌颌颈联合根治术或部分下颌骨切除术。根据气管插管的难易程度及导管对手术区域是否有影响,全麻诱导后分别经口明机插管或经鼻插管。有2例拔管后发生窒息,1例下颌骨癌及下颌骨超半切除同侧颈清扫术,术后8h完全清醒。拔管后立即窒息,经口重新插管,因咽喉暴露不清,用舌钳强行提起舌头盲探性插入导管,同时气管造口,吸氧5min转危为安。另1例右侧腮腺癌,行根治术,插管时发现喉向右侧移位且暴露困难。术毕咳嗽吞咽反射明显恢复,但拔管后发生窒息。
Our hospital from 1989 to 1992 surgical treatment of oral and maxillofacial cancer 20 cases of tongue and neck combined radical mastectomy or partial mandibular resection. According to the ease of endotracheal intubation and whether the impact of the catheter on the surgical field, after induction of general anesthesia by mouth or intubation nasal intubation. There were 2 cases of asphyxia after extubation, 1 case of mandibular cancer and mandibular superficial resection ipsilateral neck dissection, fully awake after 8h. Asphyxial extubation immediately after oral re-intubation, due to throat exposure is unclear, tongue forceps forced to lift the tongue of the blind probe into the catheter, and tracheostomy, oxygen transfer to safety. Another case of right parotid gland cancer, radical mastectomy, intubation, right throat shift and exposure difficulties. Cough swallowing reflex surgery significantly recovered, but asphyxia after extubation.