Kaylie David M, Wax Mark K
Oregon Health & Science University Portland, Oregon 97201, USA.
Am J Otolaryngol. 2002 Sep-Oct;23(5):300-2. doi: 10.1053/ajot.2002.124192.
Bronchoscopic subcutaneous dilatational tracheostomy is fast becoming the method of choice for securing an airway in chronic ventilated patients in an intensive care setting. Many studies have demonstrated that it is a cost-effective and safe procedure in experienced hands. Complications appear to be equivalent to those encountered in open tracheostomy. Subcutaneous emphysema following tracheostomy is a rare occurrence. Only 3 cases have been described following percutaneous dilatational tracheostomy. Management can be quite complex.
Retrospective review with case report of a patient with massive subcutaneous emphysema following percutaneous tracheostomy.
Massive subcutaneous emphysema following percutaneous tracheostomy is a major complication that is rarely encountered. When due to a posterior tracheal wall tear, management consists of bypassing the laceration and allowing it to heal secondarily.
在重症监护环境中，支气管镜下经皮扩张气管切开术正迅速成为为慢性通气患者建立气道的首选方法。许多研究表明，在经验丰富的医生操作下，这是一种具有成本效益且安全的手术。其并发症似乎与开放性气管切开术相当。气管切开术后发生皮下气肿较为罕见。经皮扩张气管切开术后仅报道过3例。处理起来可能相当复杂。
对1例经皮气管切开术后发生大量皮下气肿的患者进行回顾性分析并报告病例。
经皮气管切开术后发生大量皮下气肿是一种罕见的主要并发症。若由气管后壁撕裂所致，处理方法包括绕过撕裂处，使其二期愈合。
