Kang F C, Tsai Y C, Jiang C Y, Chen H P, Chang C L
Department of Anesthesiology, National Cheng Kung University, College of Medicine, Tainan, Taiwan, R.O.C.
Acta Anaesthesiol Sin. 1996 Dec;34(4):239-42.
Tracheomalacia is a condition characterized by weakness of the tracheal walls and supporting cartilage. It may be congenital, occurring in association with other lesions, such as vascular ring, tracheoesophageal fistula, dyschondroplasia, congenital cysts or tumors, or it may be acquired, most commonly as a result of protracted endotracheal intubation and less often of irradiation, trauma or neoplasm. We present a case of acquired tracheomalacia in a 15-year-old boy, a victim of Proteus syndrome (hemihypertrophy, subcutaneous tumors, and macrodactyly), who had congenital scoliosis with secondary chronic restrictive pulmonary disease, for which he was admitted to our hospital for surgical correction of the spine. Unfortunately, his conditions, particularly of respiratory, worsened after the operation, which called for an emergent tracheostomy. During the procedure, high airway pressure and CO2 retention developed, and an extreme narrowing of the tracheal lumen was revealed by fiberoptic bronchoscopy. Acquired tracheomalacia was diagnosed. The probable mechanisms, diagnostic tests, and treatments of tracheomalacia are hereunder discussed.
气管软化是一种以气管壁和支撑软骨薄弱为特征的病症。它可能是先天性的，与其他病变相关，如血管环、气管食管瘘、软骨发育异常、先天性囊肿或肿瘤；也可能是后天获得性的，最常见的原因是长期气管插管，较少见的原因是放疗、创伤或肿瘤。我们报告一例15岁男孩获得性气管软化病例，该男孩患有变形综合征（半身肥大、皮下肿瘤和巨指症），伴有先天性脊柱侧弯继发慢性限制性肺病，因脊柱手术矫正入院。不幸的是，术后他的病情，尤其是呼吸状况恶化，需要紧急气管切开术。术中出现高气道压力和二氧化碳潴留，纤维支气管镜检查显示气管腔极度狭窄。诊断为获得性气管软化。本文将讨论气管软化的可能机制、诊断测试和治疗方法。
