Iwamoto Tatsushige, Takasugi Yoshihiro, Hiramatsu Kenji, Koga Yoshihisa, Konishi Tatsuo, Kozuka Kensuke, Murakami Takamichi
Department of Anesthesiology, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-sayama, 589-8511, Japan.
J Anesth. 2009;23(2):260-5. doi: 10.1007/s00540-008-0716-1. Epub 2009 May 15.
The incidence of a tracheal bronchus--that is, a congenitally abnormal bronchus originating from the trachea or main bronchi--is 0.1%-2%. Serious hypoxia and atelectasis can develop in such patients with intubation and one-lung ventilation. We experienced a remarkable decrease in peripheral oxygen saturation (SpO2) and a rise in airway pressure during placement of a double-lumen endobronchial tube in a patient with patent ductus arteriosus and tracheal bronchus. Substitution of the double-lumen tube with a bronchial blocker tube provided secure isolation of the lung intraoperatively. A type I tracheal bronchus and segmental tracheal stenosis were identified on postoperative three-dimensional (3D) computed tomographic (CT) images. Preoperative examination of chest X-rays, CT images, and preoperative tracheal 3D images should preempt such complications and assist in securing safe and optimal one-lung ventilation.
气管支气管（即起源于气管或主支气管的先天性异常支气管）的发生率为0.1% - 2%。此类患者在插管和单肺通气时可出现严重低氧血症和肺不张。我们在一名患有动脉导管未闭和气管支气管的患者放置双腔支气管导管期间，观察到外周血氧饱和度（SpO2）显著下降，气道压力升高。用支气管封堵导管替代双腔导管可在术中实现肺的安全隔离。术后三维（3D）计算机断层扫描（CT）图像显示为I型气管支气管和节段性气管狭窄。术前胸部X线、CT图像以及术前气管3D图像检查应可预防此类并发症，并有助于确保安全且最佳的单肺通气。
