Nakada Junya, Nagai Sayo, Nishira Masao, Hosoda Renko, Matsura Tatsuya, Inagaki Yoshimi
Department of Anesthesiology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya 464-8681, Japan.
Anesth Analg. 2008 Apr;106(4):1218-9, table of contents. doi: 10.1213/ane.0b013e3181684fbb.
A 78-yr-old man was admitted to our hospital because of repeated episodes of pneumonia. Both fiberoptic bronchoscopy and esophagoscopy revealed a large tracheoesophageal fistula and protrusion of the metal stent from the esophagus into the trachea. Placement of a Dumon stent was planned for sealing this fistula under general anesthesia. Anesthetic management is difficult because of the care needed to prevent aspiration of esophageal contents and diversion of oxygen through the fistula into the stomach from the trachea when patients are under mechanical ventilation. Our method of sealing a large tracheoesophageal fistula with a Sengstaken-Blakemore tube was performed successfully.
一名78岁男性因反复发生肺炎入住我院。纤维支气管镜检查和食管镜检查均显示存在一个较大的气管食管瘘，且金属支架从食管突出至气管。计划在全身麻醉下放置杜蒙支架以封闭此瘘。麻醉管理颇具难度，因为在患者机械通气时，需要注意防止食管内容物误吸，以及氧气通过瘘从气管进入胃内。我们用三腔二囊管成功封堵了一个较大气管食管瘘的方法。
