Jougon J, Ballester M, Choukroun E, Dubrez J, Reboul G, Velly J F
Thoracic Surgery Unit, Centre Médico-Chirurgical, Haut Lévèque Hospital, Pessac, France.
Ann Thorac Surg. 2000 Jan;69(1):216-20. doi: 10.1016/s0003-4975(99)01129-7.
Postintubation tracheobronchial rupture is usually responsible for unstable intraoperative or postoperative conditions, and its management is discussed. We insist on conservative treatment as a viable alternative after late diagnosis of postintubation tracheobronchial rupture.
We conducted a retrospective study including 14 consecutive patients treated between April 1981 and July 1998.
Twelve tracheobronchial ruptures occurred after intubation for general surgery and two after thoracic surgery. In all cases, the tear consisted of a linear laceration of the posterior membranous wall of the tracheobronchial tree ranging from 2 to 6 cm. One death occurred in a very weak patient unfit to undergo a redo operation for surgical repair. Seven patients were treated conservatively and cured without sequelae. Six patients underwent surgical repair, of whom 2 were diagnosed and repaired intraoperatively.
Aggressive surgical repair is not always mandatory after delayed diagnosis of iatrogenic tracheobronchial rupture. Conservative treatment must often be considered, except after lung resection.
气管支气管插管后破裂通常是术中或术后病情不稳定的原因，本文对其治疗方法进行了探讨。我们坚持认为，对于气管支气管插管后破裂的晚期诊断，保守治疗是一种可行的替代方法。
我们进行了一项回顾性研究，纳入了1981年4月至1998年7月期间连续治疗的14例患者。
12例气管支气管破裂发生在普外科插管后，2例发生在胸科手术后。所有病例中，撕裂均为气管支气管树后壁的线性裂伤，长度为2至6厘米。1例非常虚弱、不适合再次手术修复的患者死亡。7例患者接受保守治疗并治愈，无后遗症。6例患者接受了手术修复，其中2例在术中被诊断并修复。
医源性气管支气管破裂延迟诊断后，积极的手术修复并非总是必要的。除肺切除术后外，通常必须考虑保守治疗。
