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[两例气管支气管破裂患者的成功保守治疗]

[Successful conservative management in two patients with a tracheobronchial rupture].

作者信息

Pérez y Pérez M, de Ruiter G R, Mannes G P

机构信息

Afd. Longziekten, Ziekenhuis Leyenburg.

出版信息

Ned Tijdschr Geneeskd. 2004 Mar 20;148(12):579-83.

Abstract

A 30-year-old woman with blunt chest trauma after falling from a horse appeared to have a haematothorax. Bronchoscopy showed a bronchial rupture of the posterior segment of the right upper lobe. As her condition was stable, a policy of expectant management was instigated. She recovered without problems. A 73-year-old woman with an ileus of the small intestine had, after several intubations, a tracheal rupture. Due to her poor condition a policy of conservative management was followed. The rupture healed in 2 months. The patient died due to her abdominal problems. Tracheo-bronchial ruptures are rare, mostly caused by blunt chest trauma or iatrogenic due to complicated intubations. Acute therapy involves the optimalization of ventilation. In certain selected cases following a policy of expectant management may be successful.

摘要

一名30岁女性从马背上摔下后发生钝性胸部创伤,似乎有血胸。支气管镜检查显示右上叶后段支气管破裂。由于她的病情稳定,采取了观察等待的治疗策略。她顺利康复。一名73岁女性患有小肠肠梗阻,在多次插管后发生气管破裂。由于她的病情较差,采取了保守治疗策略。破裂在2个月内愈合。患者因腹部问题死亡。气管支气管破裂很少见,主要由钝性胸部创伤或因复杂插管导致的医源性损伤引起。急性治疗包括优化通气。在某些特定情况下,采取观察等待的治疗策略可能会成功。

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