Yoshpe N, Brodsky L, Ruben R J
Int J Pediatr Otorhinolaryngol. 1986 Feb;11(1):47-60. doi: 10.1016/s0165-5876(86)80027-1.
Direct effects of the tracheotomy tube and cuff on glottic, subglottic and tracheal mucosa have been well described. Little work has been done on the effects of tracheotomy on the distal tracheobronchial tree. Ten beagle puppies underwent tracheotomy and were sacrificed at 18, 24, 36, 48 and 72 h. The trachea was studied for changes in cilia, epithelium, submucosal reaction and mucous production at the level of the tracheostome, tracheotomy tube tip, carina and right mainstem bronchus. Severe changes of epithelial erosion and ulceration with submucosal inflammatory reaction were noted as early as 18 h and persisted through 24 h. Some resolution of inflammation and progression to squamous metaplasia were seen at 36, 48 and 72 h. Changes in mucous gland activity varied widely. The traumatic effects of tracheotomy on normal tracheal anatomy and physiology and their clinical implications are discussed.
气管切开插管及套管对声门、声门下和气管黏膜的直接影响已有详尽描述。关于气管切开术对远端气管支气管树的影响，相关研究较少。十只比格幼犬接受气管切开术，并分别于18、24、36、48和72小时后处死。研究气管造口处、气管切开插管尖端、隆突和右主支气管水平的气管，观察纤毛、上皮、黏膜下反应和黏液分泌的变化。早在18小时就观察到上皮糜烂和溃疡并伴有黏膜下炎症反应的严重变化，且持续至24小时。在36、48和72小时可见炎症有所消退并发展为鳞状化生。黏液腺活动的变化差异很大。本文讨论了气管切开术对正常气管解剖结构和生理功能的创伤性影响及其临床意义。
