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[一根重复使用的吸痰导管破裂并产生了气管支气管异物]

[A reused suction catheter was broken and produced a tracheobronchial foreign body].

作者信息

Tabuchi Y, Kitagawa H, Shigemori S, Nosaka S, Amakata Y

机构信息

Department of Anesthesia, Nagahama City Hospital.

出版信息

Masui. 1996 Jun;45(6):756-9.

PMID:8752780
Abstract

We present a rare case involving a broken suction catheter that became lodged in the tracheobronchial tree. An eight-month-old infant was scheduled for hernioplasty. Following intubation with a 4 French (Fr.) endotracheal tube, a 5 Fr. reused suction catheter was applied for suctioning a moderate amount of secretion. This catheter had been resterilized by ethylene oxide gas (EOG). Insertion of the catheter into the tube was not done smoothly, and we could not obtain any secretion. During the extraction of the suction catheter by force, the catheter broke. The distal fragment (20 cm length) seemed to have been lodged in the tracheobronchial tree. Prior to its removal by bronchoscopy, the endotracheal tube was extubated. Fortunately the remaining part of the catheter come out with the tube. Ten cm of the fractured catheter was included in the tube and 5 cm protruded from the tube. The catheter of smaller diameter is easy to be broken even by weaker force. After resterilization by EOG for once, there was no change in length and force at breaking point. Elongation of the broken catheter (85.5%) was less compared with the new sample (155%). At the breaking point, half of the cross section was very smooth and looked as if it had been cut by a razor, while the other half appeared to have been broken by pulling. The break may have started from the crack which had occurred at the insertion or resterilization. Therefore, we should restrict the reuse of small suction catheters, and should always utilize the catheter of the largest size possible.

摘要

我们报告一例罕见病例,一根吸痰导管断裂并卡在气管支气管树中。一名8个月大的婴儿计划进行疝修补术。在用4法国(Fr.)气管内导管插管后,使用一根5 Fr.的重复使用的吸痰导管抽吸适量分泌物。该导管已通过环氧乙烷气体(EOG)重新消毒。将导管插入气管内导管时不顺畅,且未吸出任何分泌物。在用力拔出吸痰导管的过程中,导管断裂。远端碎片(长度为20 cm)似乎卡在了气管支气管树中。在通过支气管镜取出之前,先拔出了气管内导管。幸运的是,导管的其余部分随气管内导管一起拔出。断裂导管的10 cm在气管内导管内,5 cm从气管内导管中伸出。直径较小的导管即使受到较小的力也容易断裂。经EOG重新消毒一次后,导管长度和断裂点处的受力没有变化。与新样本相比,断裂导管的伸长率(85.5%)较小(新样本为155%)。在断裂点处,横截面的一半非常光滑,看起来像是被剃须刀切割过,而另一半似乎是被拉扯断裂的。断裂可能始于插入或重新消毒时出现的裂缝。因此,我们应限制小吸痰导管的重复使用,并应始终尽可能使用最大尺寸的导管。

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