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金属探条的一部分导致气管内导管部分阻塞;病例报告及文献综述

Partial Obstruction of the Endotracheal Tube by a Part of the Metallic Stylet; Case Report and Review of the Literature.

作者信息

Assiri Abdullah M, Alhelali Abdullah, Al-Benhassan Ibrahim, Abo Hamed Saeed, Alkathiri Assaf, Miskeen Elhadi, Alqarny Mohammed

机构信息

Department of Surgery, College of Medicine, Najran University, Najran, Saudi Arabia.

Otolaryngology Department, Abha Children Hospital & Aseer Central Hospital, Abha, Saudi Arabia.

出版信息

Int Med Case Rep J. 2023 Aug 24;16:485-489. doi: 10.2147/IMCRJ.S414298. eCollection 2023.

Abstract

Endotracheal intubation is common in the emergency department, intensive care units, and operating rooms. It involves the insertion of an endotracheal tube (ETT) through the mouth or nose into the trachea to maintain a patent airway and facilitate mechanical ventilation. Using a stylet during intubation can guide the ETT through the vocal cords. However, complications can arise when the stylet is not removed after successful intubation. Herewith, we reported a patient who was two years old and suffered from respiratory failure. However, in the first 12 hours, we observed a foreign body in the trachea, a small end of a metal stylet immediately removed by bronchoscope. This case demonstrates that multiple uses of a stylet, especially by a single user, can result in impaction of the stylet in the ETT during intubation, requiring force when the stylet is withdrawn after intubation, which can result in breakage, shearing, and retention of the stylet or plastic sheath in the lumen of the ETT.

摘要

气管插管在急诊科、重症监护病房和手术室很常见。它包括通过口腔或鼻腔将气管内导管(ETT)插入气管,以维持气道通畅并便于机械通气。插管时使用管芯可引导ETT通过声带。然而,插管成功后若未取出管芯,可能会出现并发症。在此,我们报告一名两岁的呼吸衰竭患者。然而,在最初的12小时内,我们在气管中发现了一个异物,一根金属管芯的小末端通过支气管镜立即取出。该病例表明,多次使用管芯,尤其是由单一使用者使用时,可能会导致插管过程中管芯嵌入ETT,插管后拔出管芯时需要用力,这可能会导致管芯或塑料护套在ETT管腔内断裂、剪切并残留。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6a/10461753/b03027c85a34/IMCRJ-16-485-g0001.jpg

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