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双侧小脑卒中患者长期气管插管继发气管糜烂：一例报告

Tracheal Erosion Secondary to Prolonged Endotracheal Intubation in a Patient With Bilateral Cerebellar Stroke: A Case Report.

作者信息

Peediyakkal Mohamed Zuhail K, Thurakkal Ashib, George Saibu, Chengamaraju Dinesh, Kannappilly Nevin, Sidhique Saifil, Nashwan Abdulqadir J

机构信息

Critical Care Medicine, Hamad Medical Corporation, Doha, QAT.

Nursing and Midwifery Research, Hamad Medical Corporation, Doha, QAT.

出版信息

Cureus. 2025 Jul 31;17(7):e89105. doi: 10.7759/cureus.89105. eCollection 2025 Jul.

DOI:10.7759/cureus.89105
PMID:40895897
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12397833/
Abstract

Tracheal erosion is a rare but life-threatening complication of prolonged endotracheal intubation, especially in medically complex patients. We report a case of a 70-year-old male with multiple comorbidities, including bilateral cerebellar stroke, multi-infarct dementia, and heart failure with reduced ejection fraction, who developed tracheal erosion secondary to prolonged endotracheal intubation of 265 days. Computed tomography revealed that the endotracheal tube had pierced the anterior wall of the trachea. Due to extensive tracheal erosion and the patient's poor surgical candidacy, tracheostomy was not feasible. The patient was managed conservatively under multidisciplinary care. This case highlights the diagnostic and management challenges of a tracheal injury in critically ill patients and reinforces the importance of early airway intervention, close tube monitoring, and individualized management strategies.

摘要

气管糜烂是长时间气管插管罕见但危及生命的并发症，尤其在病情复杂的患者中。我们报告一例70岁男性患者，有多种合并症，包括双侧小脑中风、多发梗死性痴呆以及射血分数降低的心力衰竭，该患者在气管插管265天后发生气管糜烂。计算机断层扫描显示气管插管已穿透气管前壁。由于气管广泛糜烂且患者手术耐受性差，气管造口术不可行。该患者在多学科护理下接受保守治疗。本病例凸显了重症患者气管损伤的诊断和管理挑战，并强化了早期气道干预、密切导管监测及个体化管理策略的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfb9/12397833/0c645ce8eea3/cureus-0017-00000089105-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfb9/12397833/320b5e73c834/cureus-0017-00000089105-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfb9/12397833/228fa6cb61c9/cureus-0017-00000089105-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfb9/12397833/0c645ce8eea3/cureus-0017-00000089105-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfb9/12397833/320b5e73c834/cureus-0017-00000089105-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfb9/12397833/228fa6cb61c9/cureus-0017-00000089105-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfb9/12397833/0c645ce8eea3/cureus-0017-00000089105-i03.jpg

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本文引用的文献

1
Postintubation Tracheal Perforation While on Long-Term Steroid Therapy: A Case Report.长期激素治疗期间发生的气管插管后气管穿孔：病例报告。
J Emerg Med. 2021 Mar;60(3):380-383. doi: 10.1016/j.jemermed.2020.11.001. Epub 2020 Dec 9.
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Tracheal lacerations after endotracheal intubation: a proposed morphological classification to guide non-surgical treatment.气管插管后气管裂伤：一种指导非手术治疗的形态学分类方法。
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气管插管后气管破裂：一项文献系统综述
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Postintubation tracheal stenosis.气管插管后气管狭窄
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Post-intubation tracheal rupture. A report on ten cases.
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