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[支气管破裂。双腔管使用罕见并发症的诊断与治疗]

[Bronchial rupture. Diagnosis and therapy of a rare complication of the use of double-lumen tubes].

作者信息

Jooss D, Zeiler D, Muhrer K, Hempelmann G

机构信息

Abteilung Anaesthesiologie und Operative Intensivmedizin, Justus-Liebig-Universität Giessen.

出版信息

Anaesthesist. 1991 May;40(5):291-3.

PMID:1867370
Abstract

For anesthesia during thoracic surgery, it is common to use a double-lumen endotracheal tube for one-lung ventilation. Double-lumen tubes protect the bronchial system of the healthy lung from being occluded by blood or pus coming from the operated lung. Therefore, in cases of lung abscess, bronchial hemorrhage, lung cyst, or localized lung infection the use of a double-lumen tube is advisable. Facilitating operation and reduced operating time are further advantages of intubation with a double-lumen tube for independent ventilation of both lungs. Due to the rigidity of these tubes, however, there are disadvantages such as injuries to the trachea and bronchial system. We report a case of rupture of the left main bronchus after insertion of a Carlens tube. The intraoperative symptoms of airway leakage are demonstrated, the process of locating and repairing the injury is described. In our case the postoperative course was not complicated; the patient left the hospital 10 days after operation. Causes of bronchial rupture, its therapy, and prophylactic measures are also discussed.

摘要

对于胸外科手术中的麻醉,使用双腔气管导管进行单肺通气很常见。双腔导管可保护健侧肺的支气管系统不被来自患侧肺的血液或脓液阻塞。因此,在肺脓肿、支气管出血、肺囊肿或局限性肺部感染的病例中,建议使用双腔导管。双腔导管插管用于双肺独立通气的进一步优点是便于手术操作并缩短手术时间。然而,由于这些导管的刚性,存在诸如气管和支气管系统损伤等缺点。我们报告一例插入卡伦斯导管后左主支气管破裂的病例。展示了气道漏气的术中症状,描述了损伤定位和修复的过程。在我们的病例中,术后过程并不复杂;患者术后10天出院。还讨论了支气管破裂的原因、治疗方法和预防措施。

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