气管插管下声门下气道异物取出术的经验：一例病例报告。
An experience of subglottic airway foreign body removal in a patient under tracheal intubation: a case report.
作者信息
Tanaka Shiori, Yoshida Keisuke, Muramatsu Kenichi, Yamagishi Shigeki, Obara Shinju, Watanabe Kazuhiro
机构信息
Department of Anesthesiology, Aidu Chuo Hospital, 1-1, Tsuruga-machi, Aizuwakamatsu, Fukushima, 965-8611, Japan.
Department of Anesthesiology, Fukushima Medical University, 1, Hikariga-oka, Fukushima, Fukushima, 960-1297, Japan.
出版信息
JA Clin Rep. 2020 Oct 4;6(1):76. doi: 10.1186/s40981-020-00382-z.
BACKGROUND
Removal of an airway foreign body is challenging to anesthesiologists. We report successful removal of an extremely rare foreign body between a tracheal tube and the trachea in patients under tracheal intubation.
CASE PRESENTATION
A 57-year-old male received total aortic arch replacement and postoperative mechanical ventilation. An airway foreign body was detected just below the glottis, outside the tracheal tube during mechanical ventilation after surgery in the intensive care unit. Before the removal procedure, we planned multiple strategies to cope with unexpected airway and breathing troubles. As a result, the foreign body was successfully removed orally by using a bronchial fiber, without extubation of the tracheal tube, under general anesthesia with dexmedetomidine and ketamine.
CONCLUSIONS
We reported the successful removal of a foreign body in the subglottic airway of a patient under tracheal intubation.
背景
气道异物取出术对麻醉医生来说具有挑战性。我们报告了在气管插管患者中成功取出气管导管与气管之间极其罕见的异物的案例。
病例介绍
一名57岁男性接受了全主动脉弓置换术及术后机械通气。在重症监护病房术后机械通气期间，在声门下方、气管导管外检测到气道异物。在取出 procedure 之前，我们制定了多种策略以应对意外的气道和呼吸问题。结果，在使用右美托咪定和氯胺酮全身麻醉下，通过支气管纤维镜经口成功取出异物，未拔除气管导管。
结论
我们报告了在气管插管患者的声门下气道成功取出异物的案例。
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