Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School, Jeonju, Korea.
Korean J Anesthesiol. 2012 Mar;62(3):277-80. doi: 10.4097/kjae.2012.62.3.277. Epub 2012 Mar 21.
Tracheal rupture is a rare but serious complication that occurs after endotracheal intubation. It usually presents as a linear lesion in the membranous wall of the trachea, and is more prevalent in women and patients older than 50 years. The clinical manifestations of tracheal injury include subcutaneous emphysema and respiratory distress. We report the cases of three female patients of old age presenting tracheal rupture after endotracheal intubation. Two cases received surgical repair without complication and one recovered uneventfully after conservative management. We presume that the tracheal injuries were caused by over-inflation of cuff and sudden movement of the tube by positional change. Therefore, we recommend cuff pressure monitoring during general anesthesia and minimized movement of the head and neck at positional change.
气管破裂是一种罕见但严重的并发症，发生在气管插管后。它通常表现为气管膜壁的线性损伤，在女性和 50 岁以上的患者中更为常见。气管损伤的临床表现包括皮下气肿和呼吸困难。我们报告了 3 例老年女性气管插管后气管破裂的病例。2 例患者接受了手术修复，无并发症，1 例患者经保守治疗后恢复顺利。我们推测气管损伤是由于套囊过度充气和导管位置改变时的突然移动引起的。因此，我们建议在全身麻醉期间监测套囊压力，并在改变体位时尽量减少头部和颈部的移动。
