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全身麻醉恢复时完全性呼气期中央气道塌陷:一例报告

Complete expiratory central airway collapse at general anesthesia recovery: a case report.

作者信息

Lyu Jie, Miao Jiamin, Zhu Jihong, Chen Gang

机构信息

Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

出版信息

J Int Med Res. 2025 Jan;53(1):3000605241307865. doi: 10.1177/03000605241307865.

Abstract

Expiratory central airway collapse is a degenerative tracheobronchial disease that is often overlooked because of its nonspecific clinical features. A man was admitted for evaluation of tracheal nodules. Following bronchoscopic biopsy, a significant increase in airway pressure occurred during anesthesia recovery. Laryngospasm was suspected, and tracheal intubation was performed. Bronchoscopy revealed an almost completely collapsed tracheal lumen. A Y-shaped silicone stent was placed using a rigid bronchoscope to support the airway, allowing spontaneous ventilation to resume. A retrospective review of the images suggested a diagnosis of excessive dynamic airway collapse. The silicone stent was removed after 2 weeks because of discomfort, and no subsequent dyspnea was observed. This case highlights that excessive dynamic airway collapse is easily missed. Anesthesiologists must be educated on this condition, maintain a thorough understanding of the patient's state and illness, and have emergency airway equipment readily available to restore ventilation promptly in cases of severe airway collapse.

摘要

呼气期中央气道塌陷是一种退行性气管支气管疾病,因其临床特征不具特异性,常被忽视。一名男性因气管结节评估入院。支气管镜活检后,麻醉恢复期间气道压力显著升高。怀疑发生喉痉挛,遂行气管插管。支气管镜检查显示气管腔几乎完全塌陷。使用硬支气管镜置入一个Y形硅胶支架以支撑气道,使自主通气得以恢复。对图像进行回顾性分析提示诊断为过度动态气道塌陷。2周后因不适取出硅胶支架,此后未观察到呼吸困难。该病例突出表明过度动态气道塌陷很容易被漏诊。必须对麻醉医生进行关于这种情况的培训,使其全面了解患者的状态和病情,并随时备有紧急气道设备,以便在严重气道塌陷时能迅速恢复通气。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c51/11724404/28ff039a67bc/10.1177_03000605241307865-fig1.jpg

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