Service de Pneumologie et d'Oncologie Thoracique, CHU Caen, Caen, France.
Service d'ORL et de chirurgie cervico-faciale, CHU Caen, Caen, France.
Thorax. 2021 Jun;76(6):632-633. doi: 10.1136/thoraxjnl-2020-215727. Epub 2021 Jan 29.
We present the cases of two laryngectomised patients who were treated for granulomas of the tracheostomy orifice with a silver nitrate pencil. During tracheostomy care, the tip broke off, was aspirated and fell into the bronchial tree. Necrotising ulcerative injuries of the right bronchial tree with clear delineation were found without lesions in the subsegmental division. To prevent the risk of secondary stenosis of the small airways induced by the spread of silver nitrate, we did not irrigate with saline solution as previously reported. Antibiotherapy and endoscopic monitoring were performed. Complete healing in 4-6 weeks was found without stenosis of the bronchial tree or bleeding.
我们报告了两例接受硝酸银铅笔治疗气管造口处肉芽肿的喉切除患者。在气管造口护理过程中，笔尖折断，被吸入并落入支气管树。发现右支气管树有坏死性溃疡性损伤，分界清晰，亚段支气管无损伤。为了防止硝酸银扩散引起的小气道继发性狭窄的风险，我们没有像之前报道的那样用生理盐水冲洗。进行了抗生素治疗和内镜监测。4-6 周后发现完全愈合，支气管无狭窄或出血。
