Brichet A, Verkindre C, Ramon P, Marquette C H
Clinique des Maladies Respiratoires, Hôpital A.-Calmette, CHRU de Lille.
Rev Mal Respir. 1999 Nov;16(4 Pt 2):685-92.
Post intubation tracheal stenosis (STPI) is a rare but serious complication of tracheal intubation and/or tracheotomy. The epidemiology has changed over the last twenty years. The diagnosis is sometimes difficult to establish on clinical grounds alone. Flexible bronchoscopy is often necessary to confirm the diagnosis and to influence treatment. The ideal curative treatment is surgical resection of the stenosis with end-to-end tracheal anastomosis. In patients presenting with definitive or transitory contraindications to this treatment there is a place for interventional endoscopy. Rigid bronchoscopy enables mechanical dilatation of the STPI which can be associated with Nd-Yag laser ortracheal endoprostheses. In certain cases interventional bronchoscopy may be curative. However in all cases the management of such lesions remains multi-disciplinary involving pulmonologists, thoracic surgeons, otolaryngologists and anaesthetists.
气管插管后气管狭窄(STPI)是气管插管和/或气管切开术一种罕见但严重的并发症。在过去二十年中,其流行病学情况已经发生了变化。有时仅根据临床症状很难确诊。通常需要进行可弯曲支气管镜检查来确诊并指导治疗。理想的治疗方法是手术切除狭窄部位并进行气管端端吻合术。对于存在明确或暂时禁忌该治疗方法的患者,介入性内镜检查有其应用价值。硬质支气管镜可对气管插管后气管狭窄进行机械扩张,还可联合钕钇铝石榴石激光或气管内支架使用。在某些情况下介入性支气管镜检查可能具有治愈效果。然而,在所有情况下,此类病变的管理仍需多学科协作,涉及肺科医生、胸外科医生、耳鼻喉科医生和麻醉医生。