Symbas P N, Hatcher C R, Boehm G A
Ann Thorac Surg. 1976 Nov;22(5):473-7. doi: 10.1016/s0003-4975(10)64456-6.
During the past ten years, 20 patients with acute penetrating tracheal injury (15 cervical and 5 thoracic) have been treated at Grady Memorial Hospital. Ten of the 20 patients had other major associated injuries: 6 had esophageal wounds, 5 had arterial injuries, and 2 had additional wounds. In the first 5 patients treatment of the tracheal injuries consisted of tracheostomy alone. Later on, the tracheal wounds were managed according to type, site, size, and the type of other organ injury. Repair of the tracheal wound and tracheostomy were done in 3 patients, repair of the tracheal wound and temporary tracheal intubation in 4 patients, tracheocutaneous stoma in 1 patient, temporary tracheal intubation alone in 4 patients, and observation alone in 3 patients. Seventeen patients recovered from their injuries and 3 died from sepsis, respiratory insufficiency, or cerebrovascular accident. All 3 deceased patients had other major injuries. This experience suggests that the treatment of penetrating tracheal injury should depend upon the type, size, and site of the wound and the type of coexistent injury to other organs, and that primary repair of the tracheal wound can be carried out in the majority of the patients.
在过去十年间，格雷迪纪念医院共收治了20例急性穿透性气管损伤患者（15例为颈部损伤，5例为胸部损伤）。20例患者中有10例还伴有其他严重损伤：6例有食管伤口，5例有动脉损伤，2例有其他伤口。最初的5例患者仅接受了气管造口术来治疗气管损伤。后来，气管伤口的处理根据伤口类型、部位、大小以及其他器官损伤的类型而定。3例患者进行了气管伤口修复和气管造口术，4例患者进行了气管伤口修复和临时气管插管，1例患者进行了气管皮肤造口，4例患者仅进行了临时气管插管，3例患者仅接受观察。17例患者伤愈康复，3例患者死于败血症、呼吸功能不全或脑血管意外。所有3例死亡患者均伴有其他严重损伤。这一经验表明，穿透性气管损伤的治疗应取决于伤口的类型、大小和部位以及其他器官并存损伤的类型，并且大多数患者可以进行气管伤口的一期修复。
