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題名 | Overinflated Cuff Causes Tracheal Stenosis in Inhalation Injury Patient: A Case Report=燒傷病患接受氣管內插管因氣囊過度充氣產生氣管狹窄之病例報告 |
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作者 | 楊志平; 孔祥珣; 何善臺; 鄭澄寰; 汪志雄; Yang, Chih-ping; Kong, Shang-shung; Ho, Shung-tai; Cherng, Chen-hwan; Wong, Chih-shung; |
期刊 | 醫學研究 |
出版日期 | 20010200 |
卷期 | 21:1 2001.02[民90.02] |
頁次 | 頁41-48 |
分類號 | 416.215 |
語文 | eng |
關鍵詞 | 過飽氣囊; 吸入性灼傷; 氣管狹窄; Overinflated cuff; Inhalation injury; Tracheal stenosis; |
中文摘要 | 我們報告一案例,因大面積燒傷合併吸入性灼傷需要氣管內呼吸管及呼吸器維持呼吸道通暢。病患於拔管後,漸漸產生呼吸道窘迫的情形,而需再次插管維持呼吸道。 經檢查,診斷為會厭下氣管狹窄。追查其原因,除了吸入性灼傷這個重要原因,我們發現病患於住院當中,氣管內管的氣囊壓力並無持續監測且胸部X光放射檢查顯示氣囊有過飽的情形。雖然,不是每個吸入性灼傷的病患都會導致氣管狹窄的後遺症,但是過飽的氣囊導致氣管傷害加重,而成為導致氣管狹窄的重要促進因子。 |
英文摘要 | The endotracheal tube with high volume low pressure cuff is always recommended for burned patients because of a lower incidence of severe mucosal damage. A 36 year-old male was intubated for inhalation injury. Shortness of breath and stridor gradually developed after extubation, which required emergent reintubation. Subglottic stenosis was diagnosed. Circumferential tracheal resection with end-to-end anastomosis was performed. By reviewing the previous chest x-ray, an overinflated cuff was observed that might be responsible for this complication. A high cuff pressure of the endotracheal tube may cause mucosal ischemia leading to necrosis, infection, tracheomalacia, or tracheal stenosis. The subglottic stenosis may be resulted from a combination of a direct thermal injury and mechanical trauma by the tube cuff with local infection. The late symptomatic presentation of the tracheal stenosis and the causative options are discussed. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。