Ohtsuka Takashi, Nomori Hiroaki, Watanabe Ken-Ichi, Kaji Masahiro, Naruke Tsuguo, Suemasu Keiichi
Department of Thoracic Surgery, Saiseikai Central Hospital, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2006 Aug;12(4):265-6.
We report herein a patient with subglottic granuloma after removal of a minitracheostomy tube (Minitrach II, SIMS Portex Inc., Hythe, Kent, UK). The patient underwent pulmonary resection for lung cancer followed by insertion of the minitracheostomy tube for prevention of sputum retention. The tube was removed 4 days after insertion. Twelve weeks later, the patient developed severe dyspnea and stridor. Bronchoscopy showed an obstructive subglottic granuloma arising from the anterior wall. The granuloma was removed by coring out using a conventional tracheal tube, followed by local injection of methylprednisolone acetate. The patient is now asymptomatic without regrowth of the granulation tissue 12 weeks after the treatment. With complication in mind, attention should be paid to patients suffering dyspnea or stridor after removal of a minitracheostomy tube.
我们在此报告一例在拔除微型气管切开插管（Minitrach II，SIMS Portex公司，英国肯特郡海斯）后发生声门下肉芽肿的患者。该患者因肺癌接受了肺切除术，随后插入微型气管切开插管以预防痰液潴留。插管插入4天后拔除。十二周后，患者出现严重呼吸困难和喘鸣。支气管镜检查显示前壁出现阻塞性声门下肉芽肿。使用传统气管导管通过钻取术切除肉芽肿，随后局部注射醋酸甲基泼尼松龙。治疗12周后，患者目前无症状，肉芽组织未再生长。考虑到并发症，对于拔除微型气管切开插管后出现呼吸困难或喘鸣的患者应予以关注。
