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[气管插管后气管狭窄]

[Postintubation tracheal stenosis].

作者信息

Uğur Chousein Efsun Gonca, Özgül Mehmet Akif

机构信息

Clinic of Chest Diseases, Istanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.

出版信息

Tuberk Toraks. 2018 Sep;66(3):239-248. doi: 10.5578/tt.67108.

Abstract

Postintubation tracheal stenosis (PITS) is an iatrogenic complication seen increasingly often as the number of intensive care unit (ICU) bed multiply, the indications for endotracheal intubation expand and disease awareness rises. PITS has a clinical severity spectrum ranging from asymptomatic cases to patients requiring urgent interventional procedures. It should therefore always be considered in the differential diagnosis in patients with a history of intubation who present with the complaint of difficult breathing. The golden standart for diagnosis is fiberoptic/rigid bronchoscopy. Even though tracheal resection and end-to-end anastomosis (TRA) is the preferred traetment, in some selected cases and in the patients who are not candidates for surgery, bronchoscopic interventions can be life saving, temporizing until surgery is possible and even be curative.

摘要

气管插管后气管狭窄(PITS)是一种医源性并发症,随着重症监护病房(ICU)床位数量的增加、气管插管适应证的扩大以及疾病认知度的提高,其发病率日益上升。PITS的临床严重程度范围较广,从无症状病例到需要紧急介入治疗的患者都有。因此,对于有插管史且出现呼吸困难主诉的患者,在鉴别诊断时应始终考虑到PITS。诊断的金标准是纤维支气管镜/硬质支气管镜检查。尽管气管切除及端端吻合术(TRA)是首选的治疗方法,但在一些特定病例以及不适合手术的患者中,支气管镜介入治疗可能挽救生命,可作为临时措施直至能够进行手术,甚至可能治愈疾病。

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