关键词: 甲状腺切除手术, 呼吸困难, 喉返神经损伤, 喉头水肿, 气管切开

Abstract:

Acute airway complications and respiratory compromise after thyroidectomy: aetiology and management        LI Xiao-xi. Department of Vascular-thyroid-breast Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Abstract    Thyroidectomy with major respiratory compromise is uncommon complication but troublesome. Bleeding into the deep cervical space after a thyroidectomy resulted in hematoma can cause tracheal compression, laryngeal edema and respiratory compromise. Bilateral recurrent laryngeal nerve injury can result in respiratory obstruction with the vocal cords held together in a midline position. Tracheomalacia and tracheal collapse may result from thyroidectomy for patients with longstanding goiter. To the best outcome with the fewest complications of thyroidectomy, the surgeon should understand the anatomical position of key structures and use meticulous operative technique. For patient with tracheomalacia or tracheal deformity with narrowing, tracheostomy taken intra-operatively is a safe procedure and gives a good alternative to delayed endotracheal extubation in post-thyroidectomy.

Key words: thyroidectomy, difficulty in breathing, recurrent laryngeal nerve injury, laryngeal edema, tracheostomy