体外膜肺氧合（ECMO）下硅胶 Y 型支架置入治疗气管撕裂患者。
Silicone Y-stent insertion under extracorporeal membrane oxygenation (ECMO) in a patient with tracheal tear.
机构信息
Respiratory, Sunway Medical Centre Velocity, Kuala Lumpur, Malaysia.
Respiratory, National University of Malaysia Faculty of Medicine, Kuala Lumpur, Malaysia
出版信息
BMJ Case Rep. 2020 Dec 22;13(12):e236414. doi: 10.1136/bcr-2020-236414.
Tracheal tear after endotracheal intubation is extremely rare. The role of silicone Y-stent in the management of tracheal injury has been documented in the previous studies. However, none of the studies have mentioned the deployment of silicone Y-stent via rigid bronchoscope with the patient solely supported by extracorporeal membrane oxygenation (ECMO) without general anaesthesia delivered via the side port of the rigid bronchoscope. We report a patient who had a tracheal tear due to endotracheal tube migration following a routine video-assisted thoracoscopic surgery sympathectomy, which was successfully managed with silicone Y-stent insertion. Procedure was done while she was undergoing ECMO; hence, no ventilator connection to the side port of the rigid scope was required. This was our first experience in performing Y-stent insertion fully under ECMO, and the patient had a successful recovery.
经气管插管后发生气管撕裂极为罕见。在之前的研究中已经有文献证明了硅胶 Y 型支架在气管损伤管理中的作用。然而，这些研究均未提及在患者仅通过体外膜肺氧合（ECMO）支持而不通过硬质支气管镜侧孔给予全身麻醉的情况下，通过硬质支气管镜部署硅胶 Y 型支架。我们报告了一例患者，该患者在常规视频辅助胸腔镜交感神经切除术因气管插管移位导致气管撕裂，通过硅胶 Y 型支架置入成功治疗。该手术是在患者接受 ECMO 期间进行的，因此不需要将呼吸机连接到硬质支气管镜的侧孔。这是我们在完全 ECMO 下进行 Y 型支架置入的首次尝试，患者恢复顺利。
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