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[气管切开术病史]

[History of tracheotomy].

作者信息

Olszewski Jurek, Miłoński Jarosław

机构信息

Klinika Otolaryngologii i Onkologii Laryngologicznej II Katedry Otolaryngologii UM w Lodzi.

出版信息

Otolaryngol Pol. 2007;61(3):349-52. doi: 10.1016/S0030-6657(07)70442-0.

Abstract

The present notion - tracheotomy, originates from the Latin words trachea - windpipe, which comes from the combination of Latin "tracheia" and Greek "arteria" indicating an uneven road, and "tome" - cut. Procedures of pharyngotomy have a long-lasting history. First similar operations were found on the ancient Egyptian clay tablets dating back to 3600 BC. Mentions of pharyngotomy operations were found in the papyrus called Ebers's Papyrus dating back to about 1550 BC, which can obviously be treated as an encyclopaedia of the medical knowledge that the ancient Egyptians possessed. Guidelines for the person performing pharyngotomy were described in Rig Veda - the holy scriptures of Hindi medicine, about 2000 BC. Asclepiads of Prussia in Bithynia (124-156 BC), a Greek physician practising in Rome, is commonly considered the father of pharyngotomy. In the 1st century BC he documented an operation similar to pharyngotomy. Procedures similar to pharyngotomy were conducted by Claudius Galenus of Pergamon (about 130-200 AD) who was treating gladiators at the beginning of his medical career. A precise description of the technique in pharyngotomy performed by the method adopted from Antilla (3rd century AD) was presented by Paulos Aeginata (625-690 AD), whereas in modern times the first surgical pharyngotomy was performed by Antonio Brasavola (1490-1554) in 1546. In those times pharyngotomy operations were applied as life saving procedures and were associated with a desperate fight for life. The best example is given by Sanctorio Santorius (1561-1636) who pierced the trachea lumen with a trocar. All the experiences connected with the pharyngotomy technique were collected by Lorenz Heister (1683-1758) and published in his work "Surgery" in 1716. Until the end of 18th century the work finally established views about performing pharyngotomy operations. In 1856 Eugeniusz Bonchut conducted the first pharyngotomy in a child with passing an intubation tube into the trachea lumen. The operation was performed according to theoretical assumptions by Armando Trausseau (1801-1867), whose contributions to emergency pharyngotomy methods are enormous. Finally, at the beginning of the 20th century Chevalier Jackson (1865-1958) set principles for surgical techniques in pharyngotomy that still remain in force. The return to Sanctorius's method and also adaptation of Selinger's method (1953) of cannulation of blood vessels turned out to be fundamental for the further development of transdermal pharyngotomy. The first set for multistage, dilatation pharyngotomy was provided by P. Ciaglia et al. in 1985. A one-stage pharyngotomy by special forceps was described by W. M. Griggs et al. in 1990. A technique of transdermal pharyngotomy from inside the trachea was presented in 1995 by A. Fantoni with his group. Modern methods of transdermal pharyngotomy are good complementary techniques for classical methods of pharyngotomy in both emergency and chronic cases.

摘要

目前的气管切开术概念,源于拉丁词trachea(气管),它由拉丁语“tracheia”和希腊语“arteria”组合而来,“arteria”表示不平坦的道路,还有“tome”(切割)之意。咽切开术的历史源远流长。最早类似的手术可追溯到公元前3600年的古埃及泥板。在约公元前1550年的《埃伯斯纸草书》中提到了咽切开术,它显然可被视为古埃及人所拥有的医学知识百科全书。公元前约2000年的印度医学圣典《梨俱吠陀》中描述了进行咽切开术者的指导原则。比提尼亚的普鲁士的阿斯克勒庇俄斯(公元前124 - 156年),一位在罗马行医的希腊医生,通常被认为是咽切开术之父。公元前1世纪,他记录了一种类似于咽切开术的手术。佩加蒙的克劳狄乌斯·盖伦(约公元130 - 200年)在其从医生涯初期治疗角斗士时进行了类似于咽切开术的手术。保罗·埃吉纳塔(公元625 - 690年)介绍了采用安提拉(公元3世纪)方法进行咽切开术的技术精确描述,而在现代,1546年安东尼奥·布拉萨沃拉(1490 - 1554年)进行了首例外科咽切开术。在那个时代,咽切开术被用作挽救生命的手术,与为生存而进行的拼死搏斗相关。最典型的例子是桑托里奥·桑托里乌斯(1561 - 1636年),他用套管针穿刺气管腔。与咽切开术技术相关的所有经验由洛伦兹·海斯特(1683 - 1758年)收集,并于1716年发表在他的著作《外科学》中。直到18世纪末,这部著作最终确立了关于进行咽切开术的观点。1856年,欧根纽什·邦舒特在一名儿童身上进行了首例咽切开术,并将插管插入气管腔。该手术是根据阿曼德·特鲁索(1801 - 1867年)的理论假设进行的,他对紧急咽切开术方法的贡献巨大。最后,在20世纪初,谢瓦利埃·杰克逊(1865 - 1958年)确立了咽切开术的外科技术原则,这些原则至今仍然有效。回归桑托里乌斯的方法以及采用塞林格(1953年)的血管插管方法被证明是经皮气管切开术进一步发展的基础。1985年,P. 恰利亚等人提供了第一套用于多阶段扩张气管切开术的器械。1990年,W. M. 格里格斯等人描述了用特殊钳子进行的一期气管切开术。1995年,A. 法托尼及其团队提出了一种从气管内部进行经皮气管切开术的技术。现代经皮气管切开术方法在紧急情况和慢性病例中都是传统气管切开术方法的良好补充技术。

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