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[医源性喉气管狭窄。20例近期病例的随访]

[Iatrogenic laryngotracheal stenosis. A follow-up of 20 recent cases].

作者信息

Wiel E, Depret T, Chevalier D, Vilette B, Erb C, Scherpereel P

机构信息

Service d'Anesthésie-Réanimation, Centre Hospitalier Régional Universitaire, Lille.

出版信息

Cah Anesthesiol. 1996;44(1):43-8.

PMID:8762250
Abstract

The aim of this study was to analyse the follow-up of patients with a history of endotracheal intubation and/or tracheotomy because of respiratory distress, surgical necessity or long-term resuscitation. Twenty adults were followed up in a ENT facility for laryngeal or tracheal stenosis, of which 7 cases were diagnosed during 1994. This study shows that, in patients with a history of intubation, or intubation followed by tracheotomy, the stenosis developed within two months after resuscitation with a favourable outcome. After tracheotomy only, the stenosis developed later (2 months or more) with more recurrences. The diagnosis of stenosis was made on gradual or acute dyspnea. While respiratory resuscitation methods are essential and often life-saving, they are not without complications. Laryngeal and tracheal stenosis could be largely prevented by more careful techniques of endotracheal intubation and tracheotomy. Periodic endoscopic airway surveillance is useful to detect stenosis even when there is no clinical symptom.

摘要

本研究的目的是分析因呼吸窘迫、手术需要或长期复苏而有气管插管和/或气管切开史的患者的随访情况。20名成年人在耳鼻喉科机构接受了喉或气管狭窄的随访,其中7例在1994年被诊断。本研究表明,有插管史或插管后行气管切开术的患者,狭窄在复苏后两个月内出现,预后良好。仅行气管切开术后,狭窄出现较晚(2个月或更长时间),复发较多。狭窄的诊断基于逐渐或急性呼吸困难。虽然呼吸复苏方法至关重要且常常能挽救生命,但并非没有并发症。更谨慎的气管插管和气管切开技术可在很大程度上预防喉和气管狭窄。即使没有临床症状,定期的内镜气道监测也有助于检测狭窄。

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