Iwasaki M, Kaga K, Ogawa J, Inoue H, Shohtsu A
First Department of Surgery, Tokai University, School of Medicine, Kanagawa, Japan.
J Cardiovasc Surg (Torino). 1994 Jun;35(3):269-71.
Five of 238 patients who suffered blunt chest trauna required surgery to repair a tracheobronchial injury. All patients were injured in a motor vehicle accident. The site of the injury was within 2.5 cm of the carina in four patients and 5.5 cm proximal to the carina in one. Pre-, intra-, and post-operative respiratory management was facilitated by the insertion of a Univent tube, an endotracheal tube with movable blocker capable of excluding one lung. The Univent tube prevented aspiration of blood by the healthy lung and the development of acute respiratory failure. Improved control over ventilation has the secondary benefit of allowing the surgeon to assess other injuries under less duress in patients with multiple trauma.
238名钝性胸部创伤患者中有5人需要手术修复气管支气管损伤。所有患者均在机动车事故中受伤。4名患者的损伤部位在隆突2.5厘米范围内，1名患者的损伤部位在隆突近端5.5厘米处。通过插入单腔支气管导管（一种带有可移动阻断器、能够隔离一侧肺的气管内导管），促进了术前、术中和术后的呼吸管理。单腔支气管导管可防止健侧肺吸入血液以及急性呼吸衰竭的发生。更好的通气控制还有一个附带好处，即让外科医生在对多发伤患者进行手术时，能够在较小压力下评估其他损伤。
