de la Rocha A G, Kayler D
Can J Surg. 1985 Jan;28(1):68-71.
Rupture of the trachea and major bronchi usually results from blunt trauma to the chest. To define the characteristics of the condition, the mechanism of injury, presentation and hospital course, the authors reviewed seven cases of tracheobronchial rupture after blunt trauma. Four were injured in a motor vehicle accident, two had a crush injury and one child had a fall from a playground swing. The site of injury was the left main bronchus in three, membranous trachea in two and bilateral bronchi and bronchus intermedius in one patient each. Bronchoplastic repair was performed in four patients with salvage of lung tissue in three. One patient required pulmonary resection. Two patients with a laceration of the membranous trachea did not undergo operation. Two patients died secondary to associated head injuries; one patient underwent repair of the bronchus intermedius and one patient had a lacerated membranous trachea. The possible mechanisms of injury are: rapid deceleration with forward swing of the trachea, widening of the transverse diameter of the chest, exerting traction on the carina, and a rapid rise of airway pressure on impact. Surgical intervention is recommended at an early stage to avoid loss of lung tissue.
气管和主支气管破裂通常由胸部钝性创伤引起。为了明确该病症的特征、损伤机制、临床表现及住院过程，作者回顾了7例钝性创伤后气管支气管破裂的病例。4例在机动车事故中受伤，2例有挤压伤，1名儿童从游乐场秋千上跌落受伤。损伤部位：3例位于左主支气管，2例位于气管膜部，1例双侧支气管及中间支气管各1例。4例患者接受了支气管成形修复术，其中3例肺组织得以挽救。1例患者需要进行肺切除术。2例气管膜部撕裂患者未接受手术治疗。2例患者因合并头部损伤死亡；1例患者接受了中间支气管修复术，1例患者气管膜部撕裂。可能的损伤机制为：气管向前摆动导致的快速减速、胸部横径增宽对隆突施加牵引力以及撞击时气道压力迅速升高。建议早期进行手术干预以避免肺组织丧失。
