Fernández Vaquero M A, Bartolomé Cela E, Villegas Fernández F R
Servicio de Anestesiología y Reanimación, Hospital Central de la Defensa Gómez Ulla, Madrid, España.
Med Intensiva. 2009 Aug-Sep;33(6):301-5. doi: 10.1016/S0210-5691(09)72199-0.
Postintubation tracheal stenosis is a very important clinical situation. It is estimated to occur in approximately 5% to 20% of intubated or tracheostomized patients. However, 1% also suffers severe respiratory dysfunction. We report the case of a 45-year old patient who required surgery under general anesthesia (first intubation experience) after suffering severe coronary disease. The patient was admitted to the intensive care unit, connected to maintained mechanical ventilation for 9 days when he was weaned and extubated. He then suffered a picture of respiratory failure requiring reintubation (for a second time) and reconnection to the mechanical ventilator. He evolved favorably, and it was possible to wean him again with final extubation on the 12th day. At 28 days, he presented a picture of dyspnea, stridor, tachypnea and a bronchoscope examination show tracheal stenosis in the subglotic region. He was treated with laser and silicone tracheal stent, with good evolution.
气管插管后气管狭窄是一种非常重要的临床情况。据估计，在接受气管插管或气管切开术的患者中，约5%至20%会发生这种情况。然而，1%的患者还会出现严重的呼吸功能障碍。我们报告了一例45岁患者的病例，该患者在患有严重冠状动脉疾病后需要在全身麻醉下进行手术（首次插管经历）。患者被收入重症监护病房，连接机械通气维持9天后撤机拔管。随后，他出现呼吸衰竭情况，需要再次插管（第二次）并重新连接机械通气。他病情好转，第12天再次撤机并最终拔管。在第28天，他出现呼吸困难、喘鸣、呼吸急促的症状，支气管镜检查显示声门下区域气管狭窄。他接受了激光和硅胶气管支架治疗，病情好转。
