Ariza-Prota Miguel, Morales Arturo, Grajeda Jose, López-Lisbona Rosa, Cubero Noelia, Dorca Jordi, Rosell Antoni
Servei de Pneumologia, Universitat de Barcelona, Barcelona, Spain.
Departamento de Enfermedades Respiratorias, Facultad de Medicina, Pontificia Universidad, Católica de Chile, Santiago, Chile.
Chest. 2016 Dec;150(6):e147-e150. doi: 10.1016/j.chest.2016.03.027.
Hyperbaric oxygen therapy, the administration of 100% oxygen at pressures > 1 atm, is believed to promote wound healing by increasing angiogenesis and collagen synthesis. To our knowledge, this treatment modality has never been described in patients with tracheal radionecrosis. Here, we report the case of a 55-year-old man diagnosed with stage IIIB lung adenocarcinoma who was treated with chemotherapy and concomitant external intensity-modulated radiotherapy involving the left lung and mediastinum. Nine months later, he presented with neck pain, cough with mucopurulent sputum, and fever. A PET-CT scan revealed a fissure in the posterior wall of the left upper trachea. Flexible bronchoscopy showed a tracheal ulceration with a small left posterior wall fissure that extended into the mediastinum. To our knowledge, this is the first report in the literature that suggests that treatment with hyperbaric oxygen therapy, local debridement, and antibiotics is a feasible and successful management option for patients with complicated tracheal radionecrosis.
高压氧疗法是指在压力大于1个大气压的情况下给予100%的氧气，据信这种疗法可通过增加血管生成和胶原蛋白合成来促进伤口愈合。据我们所知，这种治疗方式从未在气管放射性坏死患者中被描述过。在此，我们报告一例55岁男性患者，他被诊断为IIIB期肺腺癌，接受了化疗以及累及左肺和纵隔的同步外照射调强放疗。九个月后，他出现颈部疼痛、咳黏液脓性痰和发热。PET-CT扫描显示左上气管后壁有一条裂缝。可弯曲支气管镜检查显示气管溃疡，左后壁有一个小裂缝并延伸至纵隔。据我们所知，这是文献中首次报道提示高压氧疗法、局部清创和抗生素治疗是复杂气管放射性坏死患者可行且成功的治疗选择。
