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钝性创伤性气管支气管损伤:临床路径。

Blunt Traumatic Tracheobronchial Injury: a Clinical Pathway.

机构信息

Division of Thoracic Surgery, Department of Surgery, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

出版信息

Med Arch. 2022 Dec;76(6):430-437. doi: 10.5455/medarh.2022.76.430-437.

Abstract

BACKGROUND

Motor vehicle collisions (MVC) are a major burden on healthcare systems. Saudi Arabia is one of the countries with a high mortality rate of MVC. Blunt tracheobronchial injuries are rare; however, it is a catastrophic event that requires a high center of care. Lack of experience and advanced faculty prompt early stabilization and transfer of the victim for advanced care. Due to the uncertainty of management of these injuries, we would like to share our experience in dealing with such injuries.

OBJECTIVE

To address the difficulties in initial management and transfer of patient with blunt traumatic tracheobronchial injuries.

METHODS

This is a single-center retrospective case-series study including patients admitted as cases of trauma including all age groups with blunt acute tracheobronchial injuries confirmed by imaging or bronchoscope.

RESULTS

In our study, four patients with tracheobronchial injuries were identified, and a retrospective analysis was performed. Two of the males and one of the females are adults, while the other two are pediatrics. Two of them have a right main bronchial injury and the other two have a left main bronchial injury. Posterolateral thoracotomy and bronchial anastomosis were performed on all four patients and were followed up.

CONCLUSION

In Saudi Arabia, blunt trauma is a prevalent type of injury, although tracheobronchial injuries are uncommon. In the event of trauma, a high index of suspicion of tracheobronchial injuries in a high mechanism injury warrants prompt treatment. Due to a lack of experienced and specialized hands in this field, management may be delayed, and eventually lead to unfavorable outcomes, hence we thought of a guide to facilitate the decision-making.

摘要

背景

机动车碰撞(MVC)是医疗保健系统的主要负担。沙特阿拉伯是 MVC 死亡率较高的国家之一。钝性气管支气管损伤很少见;然而,这是一个需要高度医疗中心的灾难性事件。由于缺乏经验和高级教员,受害者需要早期稳定并转移到高级护理中心。由于这些损伤的管理存在不确定性,我们希望分享我们处理此类损伤的经验。

目的

解决钝性创伤性气管支气管损伤患者初始管理和转移的困难。

方法

这是一项单中心回顾性病例系列研究,包括因创伤入院的所有年龄段的患者,包括所有年龄段的患者,均有钝性急性气管支气管损伤,通过影像学或支气管镜检查证实。

结果

在我们的研究中,确定了 4 例气管支气管损伤患者,并进行了回顾性分析。2 名男性和 1 名女性为成年人,另外 2 名是儿科患者。其中 2 人有右主支气管损伤,另外 2 人有左主支气管损伤。所有 4 例患者均行后外侧开胸术和支气管吻合术,并进行了随访。

结论

在沙特阿拉伯,钝性创伤是一种常见的损伤类型,尽管气管支气管损伤并不常见。在发生创伤时,对于高机制损伤的气管支气管损伤应保持高度怀疑,需要及时治疗。由于在该领域缺乏经验丰富和专业的人员,因此管理可能会延迟,最终导致不良结果,因此我们认为有必要制定一个指南来帮助决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3d5/10019869/790e4d0f29dd/medarch-76-430-g001.jpg

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本文引用的文献

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Severe tracheobronchial injuries: our experience.
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