Farzanegan Roya, Alijanipour Pouya, Akbarshahi Hamid, Abbasidezfouli Azizollah, Pejhan Saviz, Daneshvar Aboulghasem, Shadmehr Mohammad Behgam
Tracheal Diseases Research Center, National Research Institute of Tuberculosis & Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran.
Ann Thorac Cardiovasc Surg. 2011;17(6):544-51. doi: 10.5761/atcs.oa.11.01679. Epub 2011 Aug 17.
The number of patients with traumatic and iatrogenic tracheobronchial injuries is increasing. Early diagnosis, prompt establishment of a secure airway, and appropriate management could prevent sequelae and lead to a good outcome.
Between "1994-2007", 35 patients with major airways trauma were managed. This descriptive and retrospective study evaluates clinical findings, diagnostic approaches, initial managements, definitive surgical or nonsurgical treatments and follow-up results. SPSS was used for descriptive outcomes.
There were 27 males (77%) and 8 females, with a mean age of 28.2. There were 16 blunt, 11 penetrating and 8 iatrogenic traumas, at the level of the larynx in 1, larynx and hypopharynx in 3, laryngotracheal in 12, tracheal in 13, tracheobronchial in 1, and main bronchi in 5 patients. Fourteen patients (40%) were initially managed, and 21 patients were referred to us after their initial managements at outside hospitals. There were 7 complications (20%); one resulted in mortality (2.9%). The overall final results were good in 57.1%, acceptable in 31.4% and poor in 5.7% of patients, (mean follow-up time, 58.2 months). The respiratory status and the phonation looked better in the initially managed than the delayed managed group.
We recommend that, patients only become respiratory stable with minimum intervention and then be referred to centers with sufficient experience in airway surgery.
创伤性和医源性气管支气管损伤患者的数量正在增加。早期诊断、迅速建立安全气道以及适当的处理可预防后遗症并带来良好预后。
在1994年至2007年期间，对35例大气道创伤患者进行了处理。这项描述性回顾性研究评估了临床发现、诊断方法、初始处理、确定性手术或非手术治疗以及随访结果。使用SPSS进行描述性结果分析。
男性27例（77%），女性8例，平均年龄28.2岁。有16例钝性创伤、11例穿透性创伤和8例医源性创伤，损伤部位在喉部1例、喉和下咽3例、喉气管12例、气管13例、气管支气管1例、主支气管5例。14例患者（40%）最初接受了处理，21例患者在外部医院进行初始处理后转诊至我院。发生并发症7例（20%）；1例导致死亡（2.9%）。总体最终结果良好的患者占57.1%，尚可的占31.4%，差的占5.7%（平均随访时间58.2个月）。与延迟处理组相比，初始处理组的呼吸状况和发声情况更好。
我们建议，患者仅在最少干预下呼吸稳定后，再转诊至有足够气道手术经验的中心。
