Mori N, Masuya D, Gotou M, Nakashima T, Liu D, Ishikawa S, Yamamoto Y, Huang C, Yokomise H
Second Department of Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Kyobu Geka. 2007 Sep;60(10):899-902.
We encountered a case of tracheal stenosis post tracheostomy, so-called cuff stenosis. A 43-year-old man with ventricular septal defect (VSD) was treated by oral endotracheal intubation because of heart-failure and pneumonia, and tracheostomy was performed. He was placed on artificial ventilation for almost 3 months. Four months after discharge, he complained of dyspnea and was treated by oral endotracheal intubation again. At that time bronchofiberscopy demonstrated severe circumferential stenosis of the trachea 4 cm from the tracheostomy spot and that was compatible with the cuff site. Although the stenotic portion was dilated by an endotracheal tube, 47-days after dilation, the portion was restenosed to almost 7 mm in diameter. Therefore, surgical treatment was necessary and tracheoplasty was performed by end-to-end suture after 2 cm (4 ring) resection of trachea. Tracheoplasty is the most reliable method of treating cuff stenosis after tracheostomy.
我们遇到了一例气管切开术后气管狭窄的病例，即所谓的套管狭窄。一名43岁患有室间隔缺损（VSD）的男性因心力衰竭和肺炎接受了经口气管插管治疗，随后进行了气管切开术。他接受了近3个月的人工通气。出院4个月后，他出现呼吸困难，再次接受经口气管插管治疗。当时，支气管纤维镜检查显示，在距气管切开部位4 cm处气管出现严重的环形狭窄，该部位与套管位置相符。尽管狭窄部位通过气管内导管进行了扩张，但扩张后47天，该部位再次狭窄，直径几乎缩小至7 mm。因此，有必要进行手术治疗，并在切除2 cm（4个气管环）的气管后通过端端缝合进行气管成形术。气管成形术是治疗气管切开术后套管狭窄最可靠的方法。
