Softah Abdullateef
Department of Surgery, College of Medicine and Medical Sciences, King Khalid University, Abha and King Fahad General Hospital, Jeddah, Saudi Arabia.
West Afr J Med. 2005 Jul-Sep;24(3):234-8. doi: 10.4314/wajm.v24i3.28204.
Postintubation tracheal stenosis (PITS) occurs due to excessive pressure on the trachea by the cuff of the endotracheal tube which leads to local ischaemic necrosis of the tracheal cartilage and excessive growth of granulation tissue. The recognition of its aetiology and modifications in the design and management of endotracheal tubes have led to a diminished incidence of PITS. The management modalities that have been employed for the management of PITS include stenting, surgical resection and reconstruction, percutaneous dilatation, rigid bronchoscopic dilatation, fibreoptic assisted balloon dilatation and Nd:YAG (neodymium: yttritium-aluminum garnet) laser therapy with or without stenting.
Three female patients with a history of varying periods of endotracheal intubation after a period of acute respiratory failure who developed symptoms of tracheal stenosis 1-2 weeks post-extubationare presented. The mean age was 24 +/- 12.49 years (range = 14-38 years).
All the three patients were successfully managed by frequent, rigid bronchoscopy and gradual dilatation until the resolution of the tracheal stenosis and the return of pulmonary function tests (PFT) to normal.
Rigid bronchoscopic dilation in patients with PITS provides safe, effective tracheal dilatation and improved pulmonary function in the medium term.
气管插管后气管狭窄（PITS）是由于气管内导管的套囊对气管施加过大压力，导致气管软骨局部缺血性坏死和肉芽组织过度生长所致。对其病因的认识以及气管内导管设计和管理的改进，已使PITS的发生率降低。用于治疗PITS的管理方式包括支架置入、手术切除和重建、经皮扩张、硬质支气管镜扩张、纤维光学辅助球囊扩张以及使用或不使用支架的Nd:YAG（钕:钇铝石榴石）激光治疗。
本文报告了3例女性患者，她们在急性呼吸衰竭一段时间后有不同时长的气管插管史，拔管后1 - 2周出现气管狭窄症状。平均年龄为24±12.49岁（范围 = 14 - 38岁）。
所有3例患者均通过频繁的硬质支气管镜检查和逐步扩张成功治疗，直至气管狭窄缓解且肺功能测试（PFT）恢复正常。
PITS患者的硬质支气管镜扩张在中期可提供安全、有效的气管扩张并改善肺功能。
