环状软骨

摘要： 目的探讨全麻支撑喉镜下杓状软骨复位术治疗环杓关节脱位的安全性和效果。方法回顾性分析21例采用全麻支撑喉镜显微镜下杓状软骨复位术治疗的单侧环杓关节脱位患者的临床资料,对患者的临床特征、嗓音主观听感知评估GRBAS分级、治疗经过及疗效进行分析,评估术后一个月患者的嗓音及声带运动恢复情况。结果21例单侧环杓关节脱位患者中前脱位16例,后脱位5例;术前重度声嘶(G3级)17例,中度声嘶(G2级)4例,最长发声时间7.1±1.5 s;术后1月发声正常(G0级)17例,轻度声嘶(G1级)2例,重度声嘶(G3级)2例,最长发声时间14.7±1.9 s,手术前后声音嘶哑总分级G各级例数及最长发声时间比较差异均有统计学意义(P<0.001);术后疗效评估治愈17例(80.95%,17/21),有效2例,无效2例(9.52%,2/21),总有效率90.48%(19/21)。结论全麻支撑喉镜下杓状软骨复位术治疗环杓关节脱位安全、有效。

摘要： 目的 基于颈部CT平扫图像探讨儿童和青少年喉部的发育规律.方法 选取2008年1月至2017年12月盛京医院行颈部CT检查的儿童和青少年为研究对象.共纳入910例患者,男514例,女396例.本研究经中国医科大学附属盛京医院伦理审查委员会批准?(2018PS469K),对所有患者颈部CT进行多平面重建和测量,测量声门下和环状软骨的横径和前后径,并计算声门下/环状软骨横径比值和声门下/环状软骨前后径比值.结果 患者声门下横径和前后径分别为?(9.0±2.6)?mm、?(11.1±4.3)?mm,环状软骨横径和前后径分别为?(11.6±3.2)?mm、?(11.8±3.4)?mm,声门下/环状软骨横径和声门下/环状软骨前后径比值分别为0.78±0.08和1.19±0.09.?喉部气道内径与年龄呈正相关?(P?环状软骨横径和声门/环状软骨前后径比值与年龄不相关.结论 儿童和青少年声门下横径是喉部最狭窄的内径.随着年龄增加,喉部气道内径增大,但喉部的形态未发生明显变化.

摘要： 目的 探讨环状软骨瘤的临床特征及处理方法.方法 回顾2020年1月3日贵州医科大学附属医院收治的环状软骨瘤1例患者的临床资料,并结合文献复习进行讨论.结果 经喉裂开使用耳科磨钻行环状软骨瘤切除并局部修复治疗,患者术后恢复良好并顺利拔除气管套管.随访3个月未见喉腔狭窄及复发.结论 环状软骨瘤是一种罕见的喉良性肿瘤,诊断上需要与低级别软骨肉瘤相鉴别,治疗上以手术治疗为主,原则上尽可能保留喉的功能,全喉切除需慎重.

摘要： 近年来喉癌的发病率呈上升趋势.手术治疗仍然是喉癌的主要治疗手段,手术方式从最初确保肿瘤完全切除的喉全切除术转变为在确保肿瘤完全切除的基础上最大程度的保留喉的功能,提高患者的生存质量.而喉环状软骨上部分切除术以保留环杓单元为特点,既能完整切除肿瘤,又可保留喉的生理功能,且不需要永久性气管造瘘,在不影响生存率和局部控制率的前提下,有效改善患者的生活质量,从而得到广泛应用.本文首先概述喉癌的发病与治疗情况,其次描述喉环状软骨上部分切除术的原理与特点,最后讨论喉环状软骨上部分切除术的最新应用进展.%In recent years,the incidence of laryngeal cancer is on the rise.Surgical treatment is still the main treatment for laryngeal cancer.The surgical procedure is changed from the total laryngectomy,which originally ensures the complete removal of the tumor,to preserve the function of the larynx to the maximum extent and ensure the quality of life of the patient,while ensuring the complete excision of the tumor.However,the supracricoid partial laryngectomy (SCPL),which retains the ring scoop unit as a scaffold to reconstruct a new larynx,can completely excise the tumor while preserving the physiological functions of the larynx without requiring permanent tracheostomy.And without affecting the survival rate and local control rate under the premise of effectively improving the quality of life of patients,which has been widely used.This article first outlines the incidence and treatment of laryngeal cancer,followed by the description of the principle and characteristics of supracricoid partial laryngectomy,and finally discusses the latest application of SCPL.

摘要： Objective To evaluate the oncologic and functional outcomes of supracricoid partial laryngectomy(SCPL)in the treatment of laryngeal carcinoma.Methods A total of 298 laryngeal carcinoma patients who underwent SCPL treatment from January 2005 to December 2013 were reviewed retrospectively. Clinical data of demographic and clinical characteristics, postoperative complications, rehabilitation information,recurrence and metastasis were analysed.Survival and local control were used to evaluate the clinical outcome.Data were analyzed by SPSS 23.0 software.Results Thirty-one patients with supraglottic carcinoma underwent cricohyoidoepiglottopexy (CHEP)and 267 with glottic carcinoma underwent cricohyoidopexy(CHP)were enrolled in this study.The mean duration of followed up was 74 months, ranging from 12 to 146 months.Fifty-four cases died at last follow-up.With respect to 31 patients with supraglottic carcinoma, 5-and 10-year overall survival rates and disease specific survival rates all were 78.1%;5-and 10-year disease free survival rates were 72.1% and 63.7% respectively; and 5-and 10-year local control rates were both 84.2%.In 267 patients with glottic carcinoma, 5-and 10-year overall survival rates were 85.8% and 77.1% respectively; 5-and 10-year disease specific survival rates were 86.6% and 78.4% respectively; 5-and 10-year disease free survival rates were 80.6% and 74.2%respectively;and 5-and 10-year local control rates were 90.0%and 89.4%respectively.The survival rate of patients with glottic carcinoma at stage T 1 was higher than that at stage T2 or T3, and the disease free survival rate of patients with early stage was superior than that of patients with advance stage.Cox regression analysis showed that tumor stage T 2,and T3,tumor recurrence,and tumor metastasis were independent risk factors for survival.Furthermore, nasogastric feeding tube removal rate was 100% and the decannulation rates of SCPL were 96% in the patients with SCPL.Conclusions SCPL is a safe procedure with tumor resection for laryngeal carcinoma,with preserving of swallowing, respiration,and phonation functions,and has excellent survival and local control rates.This procedure could be considered as a standard function-sparing treatment for selected patients with laryngeal carcinoma of stages T1b-T3.%目的 分析环状软骨上部分喉切除术(supracricoid partial laryngectomy,SCPL)治疗喉癌的远期疗效.方法 回顾性分析2005年1月至2013年12月在复旦大学附属眼耳鼻喉科医院头颈外科接受SCPL治疗的298例喉癌患者的临床资料,并对术后生存率、局部控制率、功能恢复、并发症和复发转移等数据使用SPSS 23.0软件进行统计学分析.结果 267例声门型喉癌患者主要接受环状软骨舌骨会厌固定术(cricohyoidoepiglottopexy,CHEP)治疗,31例声门上型喉癌患者主要接受环状软骨舌骨固定术(cricohyoidopexy,CHP)治疗.平均随访74个月(12 ~146个月),死亡54例(18.1%).声门上型喉癌患者的5年和10年总生存率和疾病特异性生存率均为78.1%,5年和10年无病生存率分别为72.1%和63.7%,5年和10年局部控制率均为84.2%.声门型喉癌患者的5年和10年总生存率分别为85.8%和77.1%,5年和10年疾病特异性生存率分别为86.6%和78.4%,5年和10年无病生存率分别为80.6%和74.2%,5年和10年局部控制率分别为90.0%和89.4%.T1的声门型喉癌患者的生存率要高于T2和T3患者,早期声门型喉癌患者的无病生存率高于进展期患者.Cox多因素分析提示T2、T3期和肿瘤复发转移是影响患者术后生存率的独立危险因素.此外,术后鼻饲管的拔管率为100%,气管套管拔管率为96%.结论 SCPL能够完整地切除喉癌组织,保留患者较好的吞咽、呼吸和发音功能,具有较满意的远期生存率和局部控制率.SCPL可作为标准的手术方案治疗经选择的T1b-T3期声门上型和声门型喉癌.

摘要： 目的 评估超声应用在儿童全麻带套囊气管导管选择中的临床效果.方法 60例择期行扁桃体切除术的患儿随机分为A组(公式计算组),B组(超声测定环状软骨横径组),记录两组的换管例数、换管次数等.结果 两组患儿在年龄、性别、体质量、身高之间比较差异无统计学意义;B组较A组选择气管导管成功率更高(P＜0.05).结论 超声应用于儿童全麻中带套囊气管导管的选择有好的应用价值.

摘要： 目的 评价基于非先天性心脏病患儿(children without congenital heart disease,NCHD)气管环状软骨平面横径值(transverse diameter of cricoid cartilage,CD)与年龄或体型所建立的直线回归方程,比较回归方程预测先天性心脏病患儿(children with congenital heart disease,CHD)环状软骨平面的气管横径值(cricoid diameter predicted by formula,CDfomula)和超声实测值(cricoid diameter measured by ultrasound,CDultra)的一致性.方法 纳入64名NCHD,镇静后测量CDultra,记录患儿年龄、身高、体重、BMI、体表面积等数据,采用逐步向前法与CD建立线性回归模型.纳入CHD 30例和NCHD 25例,比较两组患儿CD超声测量值与线性回归模型预测值的一致性.结果 NCHD的CD值与年龄呈正相关(r=0.90,P＜0.05),回归方程为CD(cm)=0.048×年龄(岁)+0.525.两组人群CDfomulaCDultra之间存在相关性(P＜0.05),NCHD组患儿CDfomula和CDultra的相关性为0.94,而CHD组患儿CDfomula和CDultra的相关性为0.71.NCHD组和CHD组CDultm和CDfomula的偏移值分别为-0.00 cm、-0.01 cm,95％一致性界限分别为(-0.06 cm,0.05 cm)和(-0.17 cm,0.15 cm),虽然两组患儿CDultra和CDfomula的偏移相近,但是CHD组患儿的界限值宽于NCHD组患儿.结论 在建立NCHD超声测量的CD值与年龄间线性回归方程的基础上,认为CHD模型预测和超声实测的一致性不如NCHD.因此在CHD气管插管时,测量CDultra可能会使气管导管的选择更加准确和便捷.%Objective We evaluated the agreement of transverse diameters of cricoid cartilage (CD) of patients with congenital heart disease measured by ultrasound (CDultra) and the diameters that predicted by linear regression formula (CDformula),which was derived from pediatric patients without congenital heart disease (CHD).Methods After sedation,64 pediatric patients without congenital heart disease (NCHD) were included to model the linear regression equation.CD measured by ultrasound,age,weight,height,body mass index and body surface area were recorded.After model established,25 patients without CHD and 30 with CHD were included to evaluate the agreement of CD predicted by the linear regression with revised Bland-Altman analyses and CD measured by ultrasound.Results There was positive correlation between CD and age in children without CHD (r=0.90,P＜0.05).Linear regression equation was CD (cm) =0.048×age(year)+0.525.Bias in values of CDultra and CDformula were-0.00 cm and-0.01 cm.95％ limits of agreement was-0.06 cm to 0.05 cm and-0.17 cm to 0.15 cm individually.CDformula was correlated to CDultra in NCHD and CHD groups (0.94 and 0.71,P＜0.05).Conclusions In our study,we show empirical formula from children without congenital heart disease cannot predict CD of children with CHD accurately.Thus,tracheal tube in pediatric patients guided by ultrasonography may be much more accurate and convenient.

摘要： 目的 评价超声测定小儿环状软骨横径用于带套囊气管导管型号选择的准确性.方法 选择接受气管内插管全麻的患儿120例,性别不限,ASA分级Ⅰ或Ⅱ级,年龄1月～6岁,体重指数10.9 ～ 31.2 kg/m2,采用随机数字表法分为2组(n=60):A组和B组.2组患儿均采用带套囊的气管导管进行气管插管,A组根据超声测定环状软骨横径的结果选择导管型号,B组根据年龄公式选择导管型号.评价所选导管型号是否合适,如导管不合适需要更换时,记录更换次数,记录气管插管相关并发症的发生情况.结果 A组首次选择带套囊气管内导管型号的准确率为95％,高于B组(60％)(P＜0.05),2组患儿插管相关并发症发生率差异无统计学意义(P＞0.05).结论 超声测定小儿环状软骨横径用于带套囊气管导管型号选择的准确性高,值得临床推广.%Objective To evaluate the accuracy of ultrasonographic measurement of the transverse diameter of the cricoid cartilage in selecting the cuffed endotracheal tube (ETT) size for pediatric patients.Methods A total of 120 pediatric patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 1 month-6 yr,with body mass index of 10.9-31.2 kg/m2,undergoing endotracheal intubation and general anesthesia,were divided into group A and group B,with 60 pediatric patients in each group.The pediatric patients were intubated with a cuffed ETT in two groups.The ETT size was selected based on the transverse diameter of the cricoid cartilage measured by ultrasonography in group A.The ETT size was selected according to the age-based formula in group B.A tracheal leak was detected after intubation to determine whether or not the ETT size selected was appropriate.ETTs were replaced when the actually selected ones were not appropriate,and the number of replacement was recorded.The development of intubation-related complications was also recorded.Results The accurate rate of cuffed ETT size selected at the first time was 95％ in group A,and it was significantly higher than that in group B (60％) (P＜ 0.05).There was no significant difference in the incidence of intubation-related complications between the two groups (P＞0.05).Conclusion Uhrasonographic measurement of the transverse diameter of the cricoid cartilage produces higher accuracy in selecting the cuffed ETT size for pediatric patients and is worthy of clinical application.

摘要： 晚期喉癌采用根治性手术加放疗后常导致喉功能的丧失,环状软骨上喉部分切除术是近20年来在国际上得到迅速发展的喉癌功能性外科治疗喉功能保留手术方法,它主要包括两种基本术式,即环状软骨-舌骨-会厌固定术和环状骨软-舌骨固定术,以及这两种基本术式的扩展应用,即气管-环状软骨-舌骨-会厌固定术和气管-环状软骨-舌骨固定术. 1959年Majer和Rieder医师首次报道了环状软骨-舌骨固定术(CHP)治疗侵犯声门区的会厌癌,1971年Labayle和Bismuth对此又加以改进,1974年Piquet又重新定义了它的技术操作和适应证.它的手术适应证从最初的治疗侵犯前联合的会厌喉面癌发展到目前治疗声门上部癌和贯声门癌,通常这类喉癌是全喉切除术的指征.诱导化疗配合环状软骨上喉部分切除术，可以提高切缘的安全性及肿瘤的局部控制率，同时能延迟远处转移的发生，但对提高生存率影响不大。总之，环状软骨上喉部分切除术是目前喉功能保留手术中一种安全、可靠的手术方法，需进一步进行深人研究。

摘要： 公开了制备(iv)包含具有呋喃单元和2至5个重复单元的环状聚酯低聚物的环状聚酯低聚物组合物的方法。所述方法包括以下步骤：(a)使单体组合物在线型低聚步骤中反应，所述单体组合物包含：(i)双官能呋喃衍生物和(ii)二醇，以制备(iii)包含线型低聚物物类的线型低聚物组合物，(b)使(iii)线型低聚物组合物在蒸馏辅助环化(DA‑C)步骤中反应以形成(iv)环状聚酯低聚物组合物和(v)二醇副产物，其中在蒸馏辅助环化(DA‑C)步骤中通过蒸发除去(v)二醇副产物。

摘要： 本发明公开了一种三重荧光PCR法联合检测西藏环状病毒、云南环状病毒及萨斯乌瓦扎利环状病毒的引物探针组，针对西藏环状病毒的正向引物序列如SEQ ID No.1所示，针对西藏环状病毒的反向引物序列如SEQ ID No.2所示，针对云南环状病毒的正向引物序列如SEQ ID No.3所示，针对云南环状病毒的反向引物序列如SEQ ID No.4所示；针对萨斯乌瓦扎利环状病毒的正向引物序列如SEQ ID No.5所示，针对萨斯乌瓦扎利环状病毒的反向引物序列如SEQ ID No.6所示。本发明引物探针组及试剂盒可以对西藏环状病毒、云南环状病毒及萨斯乌瓦扎利环状病毒进行检测，检测灵敏度达1×103copies/ml，有效克服现有技术中对西藏环状病毒、云南环状病毒及萨斯乌瓦扎利环状病毒检测的缺失，具高度产业利用价值。

摘要： 本发明涉及使用冻干透明软骨粉生产软骨再生用组合物的方法，和使用所述方法生产的软骨再生用组合物，所述方法包括：A)制备透明软骨的步骤；B)将透明软骨冻干并粉碎和生产冻干透明软骨粉的步骤；C)从自体脂肪组织产生脂肪组织提取物的步骤；和D)产生包含冻干透明软骨粉和脂肪组织提取物的软骨再生用组合物的步骤。

摘要： 本发明的热固化性交联环状烯烃树脂组合物，将聚合性组合物加热进行开环易位聚合及交联来得到，所述聚合性组合物含有(a)环状烯烃单体100质量份、(b)[除前述(a)之外，具有两个以上聚合性不饱和键的交联剂]0.7～40质量份、(c)1分钟半衰期温度为135～200°C的有机过氧化物系热聚合引发剂1.15～15质量份、和(d)开环易位聚合催化剂。

摘要： 环状软骨按压器，涉及一种医疗器械。提供一种对整个颈部血管神经不造成压迫，可量化环状软骨按压力度，实时反应按压情况，按压的压力可控的环状软骨按压器。设有弧形弹力架和弧形按压垫；所述弧形按压垫与弧形弹力架内侧一端连接。所述弧形弹力架可采用U形或C形等弹力架。所述弧形按压垫可采用弧形硅胶按压垫或弧形橡胶按压垫等。所述弧形弹力架上最好设有压力传感器、压力显示器、压力设定器、压力调节器、松解器、压力保护器、颈部托架等中的至少一种。

摘要： 环状软骨按压器，涉及一种医疗器械。提供一种对整个颈部血管神经不造成压迫，可量化环状软骨按压力度，实时反应按压情况，按压的压力可控的环状软骨按压器。设有弧形弹力架和弧形按压垫；所述弧形按压垫与弧形弹力架内侧一端连接。所述弧形弹力架可采用U形或C形等弹力架。所述弧形按压垫可采用弧形硅胶按压垫或弧形橡胶按压垫等。所述弧形弹力架上最好设有压力传感器、压力显示器、压力设定器、压力调节器、松解器、压力保护器、颈部托架等中的至少一种。

摘要： 本实用新型公开了一种环状软骨压迫器，一种环状软骨压迫器，其特征在于：包括压迫臂、曲臂、固定臂、固定组件、指槽，所述压迫臂位于整套装置的最前端，所述压迫臂后端设置有曲臂，所述曲臂远离压迫臂的一端设置有固定臂，所述固定臂底部开设有指槽，所述固定臂外围固定安装有固定组件，本实用新型科学合理，使用安全方便，起到延伸手指的作用，测量柱与刻度的设计，让操作者更直观判断力能以方便调节按压力度，在接诊特殊病例时，一名麻醉医生使用本设备能独自更高效的在麻醉诱导的同时进行压迫环状软骨，减少相关并发症的发生，紧固装置的设计使医护人员戴上合适型号的压迫器后可进行进一步固定作用，使压迫器不容易从指端掉落。

摘要： 一种经环状软骨食管封闭装置，能够准确、有效的封闭食管，预防饱胃患者全身麻醉时反流误吸，由软垫、有机玻璃方盒、塑料气囊、连接管以及压力表组成。所述的有机玻璃方盒底面宽2cm长5cm并向上弧形突起，有机玻璃方盒内的气囊通过连接管与压力表相连接，方盒的弧形面下方粘附一3mm厚软垫。对于需要进行环状软骨压迫封闭食管的患者，在全身麻醉时将方盒的底面扣压在环状软骨处，操作者一手拇指和食指从方盒的上面压向气囊，气囊受压后产生的压力会及时显示在压力表上，从而可以准确的对环状软骨施加压力，避免仅凭手感出现的误差等。

摘要： 一种环状软骨压迫器，涉及一种医疗器械。提供一种对整个颈部血管神经不造成压迫，可量化环状软骨按压力度，实时反应按压情况，按压的压力可控的环状软骨压迫器。设有弧形弹力架和弧形按压垫；所述弧形按压垫与弧形弹力架内侧一端连接。所述弧形弹力架可采用U形或C形等弹力架。所述弧形按压垫可采用弧形硅胶按压垫或弧形橡胶按压垫等。所述弧形弹力架上最好设有压力传感器、压力显示器、压力设定器、压力调节器、松解器、压力保护器、颈部托架等中的至少一种。

摘要： 环状软骨气管切开训练模型，主要由模型胎体、气管肌肉模块、皮肤模块和仿真外壳所构成，头正中位并后仰体位，可进行常规气管切开、环甲膜穿刺、环甲膜切开等操作，形象直观，用于急救诊疗的教学与练习使用。