Tanaka Tomoharu, Torii Yuki, Furutani Hidekatsu, Harioka Tokuya
Department of Anesthesia, National Hospital Organization Kyoto Medical Center, Kyoto.
Masui. 2005 Sep;54(9):1040-2.
Fiberoptic intubation can cause laryngeal injury during blind insertion of a tracheal tube. A patient with hypopharyngeal cancer was scheduled for laser surgery and we selected nasal fiberoptic intubation due to laryngeal deformity. Just after insertion of a tracheal tube, tracheal bleeding occurred and ventilation because difficult. Emergency tracheostomy was required to restore adequate oxygenation. A piece of mucosa and blood clot was found in the lumen of the tracheal tube and hematoma was observed on the surface of arytenoid cartilage. Careful selection and optimal manipulation of the tracheal tube is important and surgical airway access should be immediately available before fiberoptic procedure in a patient with friable and vascular-rich laryngeal lesion.
在盲目插入气管导管的过程中，纤维支气管镜引导插管可能会导致喉部损伤。一名下咽癌患者计划接受激光手术，由于喉部畸形，我们选择了经鼻纤维支气管镜引导插管。气管导管插入后不久，即出现气管出血，通气变得困难。需要紧急气管切开以恢复充足的氧合。在气管导管腔内发现一块黏膜和血凝块，并且在杓状软骨表面观察到血肿。对于喉部病变脆弱且血管丰富的患者，在进行纤维支气管镜检查之前，仔细选择和优化气管导管的操作非常重要，并且应立即具备建立外科气道的条件。
