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气管切开术和插管后的罕见并发症(作者译)

[Rare complications following tracheotomy and intubation (author's transl)].

作者信息

Sigrist T, Dirnhofer R, Patscheider H

出版信息

Anaesthesist. 1981 Oct;30(10):523-7.

PMID:7304907
Abstract

Report on two cases: Case 1: A young male was tracheotomized because of respiratory insufficiency due to a thoraco-abdominal trauma. The injuries were fatal 8 hours following tracheotomy. Autopsy revealed a tube like formation located in the upper trachea, consisting of coagulated blood. The peculiar shape was caused by a splinting effect of the tracheal cannula. A trickling tracheostomal hemorrhage was found to be the causal factor. --Case 2: After long-term tracheotomy due to a laryngeal trauma a tracheostomal intubation was performed in a young male for the purpose of a surgical revision of the laryngeal injuries. Two days later sudden death occurred. Autopsy revealed a tube like formation in the upper trachea, consisting of fibrin and desquamated necrotic tracheal epithelium, which had occluded the cannula in a valve like manner. The originating mechanism of this pathological state is demonstrated. The significance of preexisting chronic tracheitis and the use of a tube with a rather rigid cuff (nylon spiral tube) as additional promoting factors are discussed.

摘要

两例病例报告

病例1:一名年轻男性因胸腹外伤导致呼吸功能不全而行气管切开术。气管切开术后8小时死亡。尸检发现气管上部有一个管状结构,由凝血块组成。其特殊形状是由气管套管的夹板作用引起的。发现微量气管造口出血是致病因素。——病例2:一名年轻男性因喉部外伤长期气管切开术后,为进行喉部损伤的手术修复而进行气管造口插管。两天后突然死亡。尸检发现气管上部有一个管状结构,由纤维蛋白和脱落的坏死气管上皮组成,其以瓣膜样方式阻塞了套管。阐述了这种病理状态的发病机制。讨论了既往慢性气管炎以及使用带有相当硬的套管(尼龙螺旋管)作为额外促发因素的意义。

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