在重症加强治疗病房内通过气管插管和气管切开建立人工气道挽救了许多患者的生命, 但气管插管和气管切开操作及护理过程中会出现许多并发症, 有些少见并发症如气管肉芽组织增生、气管损伤后瘢痕狭窄、气管软化等所致的气管狭窄易被忽视或误诊为其他疾病延误治疗, 机械通气患者出现气管肉芽组织增生、气管损伤后瘢痕狭窄等常出现人机不协调, 呼吸困难、潮气量低, 气道狭窄严重的吸痰时吸痰管插入困难。气管软化患者拔出气管插管或气管切开套管后出现呼吸困难而危及生命。早期预防、及时发现、尽早处理可提高抢救成功率, 并可缩短住院时间、降低死亡率
Citation:
张永利,万献尧,李素玮. 建人工气道患者气管狭窄的病因分析及防治. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(5): 503-504. doi:
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- 1. Schuurmans MM, Michaud GC, Diacon AH, et al. Use of an Ultrathin Bronchoscope in the Assessment of Central Airway Obstruction. Chest, 2003, 124: 735-739.
- 2. Boiselle PM, Ernst A. Recent Advances in Central Airway Imaging. Chest, 2002, 121: 1651-1660.
- 3. Sun M, Ernst A, Boiselle PM. MDCT of the central airways-- Comparison with bronchoscopy in the evaluation of complications of endotracheal and tracheostomy tubes. J thorac imaging, 2007, 22: 136- 142.
- 4. Krimsky WS, Sharief UU, Sterman DH. Topical Mitomycin C is an Effective, Adjunct Therapy for the Treatment of Severe, Recurrent Tracheal Stenosis in Adults. J Bronchol, 2006, 13: 141-143.
- 5. Bodhey NK, Gupta AK, Neelakandhan KS, et al. Fluoroscopic-guided balloon dilatation and stenting in tracheal stenosis with metallic selfexpandable stents and long-term follow-up results. Australasian Radiology, 2007, 51: 351-357.
- 6. Liu CC, Wang KM, Hsu LH. Tracheobronchial Self-expanding Metallic Stents in Patients With Central Airways Obstruction. J Bronchol, 2008, 15: 11-16.
- 7. 孙正良, 刘阳云, 冯秀荣, 等. 纤维喉镜下微波治疗喉气管良性病变. 中国内镜杂志, 2000, 6: 46.
- 8. Yasuo M, Tanabe T, Tsushima K, et al. Endobronchial argon plasma coagulation for the management of post-intubation tracheal stenosis s. Respirology, 2006, 11: 659 -6628 .