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采用改良巴克利法对一名8岁女童气管支气管损伤进行气管支气管重建:病例报告

Tracheobronchial reconstruction by inverted Barclay's method for tracheobronchial injury in an 8-year-old girl: a case report.

作者信息

Suzuki Yamato, Ishizawa Hisato, Kawai Hiroshi, Matsuda Yasushi, Hoshikawa Yasushi

机构信息

Department of Thoracic Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.

出版信息

Surg Case Rep. 2022 Mar 28;8(1):54. doi: 10.1186/s40792-022-01405-w.

Abstract

BACKGROUND

Tracheobronchial injury in children is rare but can be highly fatal in severe cases. Therefore, prompt diagnosis and treatment are required. The appropriate treatment method depends on the extent and severity of the injury.

CASE PRESENTATION

An 8-year-old girl fell from the fifth floor and was transported to a local hospital. She had a tracheobronchial injury, went into cardiopulmonary arrest during transportation to our hospital. She was revived with cardiopulmonary resuscitation, and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was commenced. Subsequently, we performed tracheobronchial reconstruction by inverted Barclay's method for tracheobronchial injury. She was switched from VA-ECMO to venovenous (VV)-ECMO 4 days postoperatively, and VV-ECMO was eventually discontinued 27 days after the surgery. The patient was awake and weaned off the ventilator on postoperative day 58. She was discharged 97 days after the surgery.

CONCLUSIONS

Tracheobronchial reconstruction by inverted Barclay's method is the preferred surgical technique when other reconstruction techniques are expected to cause excessive tension on the anastomosis of the right main bronchus.

摘要

背景

儿童气管支气管损伤较为罕见,但严重时可能致命。因此,需要及时诊断和治疗。合适的治疗方法取决于损伤的范围和严重程度。

病例介绍

一名8岁女孩从五楼坠落,被送往当地医院。她存在气管支气管损伤,在转送至我院途中发生心肺骤停。通过心肺复苏使其恢复自主循环,并开始进行静脉-动脉体外膜肺氧合(VA-ECMO)治疗。随后,我们采用改良巴克利法对气管支气管损伤进行了气管支气管重建。术后4天,她从VA-ECMO转为静脉-静脉(VV)-ECMO,最终在术后27天停用VV-ECMO。患者术后第58天清醒并脱机。术后97天出院。

结论

当预计其他重建技术会导致右主支气管吻合口张力过大时,改良巴克利法气管支气管重建是首选的手术技术。

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