气管-无名动脉瘘：诊断与手术治疗。
Tracheo-innominate artery fistula: Diagnosis and surgical management.
机构信息
Department of Head and Neck Surgery, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
出版信息
Head Neck. 2013 Dec;35(12):1713-8. doi: 10.1002/hed.23211. Epub 2013 Jan 23.
BACKGROUND
Tracheo-innominate artery fistula (TIF) is a rare and fatal complication after tracheostomy. The diagnosis, treatment, and possible prevention of this disease are discussed in this study.
METHODS
From 1976 to 2008, 14 patients with TIF were studied retrospectively.
RESULTS
All patients underwent open surgical tracheostomy. Before TIF, herald events occurred in 10 patients (8 had slight hemoptysis and 2 had innominate artery exposure). When TIF occurred, bedside aid was administered, and 5 patients lived long enough to reach the operating room. Four patients accepted median sternotomy and ligation of innominate arteries. After surgery, mediastinal infection caused the rebleeding and death of 3 patients. In conducting follow-up for 11 months, the last patient was still alive without neurological complications. The survival rate was only 7.1%.
CONCLUSION
Prompt diagnosis and surgical intervention can save the life of a patient with TIF. Prevention is vital because of the high mortality of this disease.
背景
气管-无名动脉瘘（TIF）是气管切开术后罕见且致命的并发症。本研究探讨了该病的诊断、治疗和可能的预防措施。
方法
1976 年至 2008 年，回顾性研究了 14 例 TIF 患者。
结果
所有患者均行开放式外科气管切开术。在 TIF 发生前，有 10 例患者出现先兆事件（8 例有轻微咯血，2 例无名动脉暴露）。当 TIF 发生时，进行床边急救，其中 5 例患者存活时间足够长，到达手术室。4 例患者接受正中胸骨切开术和无名动脉结扎术。手术后，纵隔感染导致 3 例患者再次出血和死亡。对 11 个月的 11 例患者进行随访，最后 1 例患者仍存活，无神经并发症。生存率仅为 7.1%。
结论
及时诊断和手术干预可以挽救 TIF 患者的生命。由于该病死亡率高，预防至关重要。
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