建人工氣道患者氣管狹窄的病因分析及防治_《中國呼吸與危重監護雜志》

作者：

張永利 , 萬獻堯 , 李素瑋

大連醫科大學附屬第一醫院中心ICU(遼寧大連 116011);

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在重癥加強治療病房內通過氣管插管和氣管切開建立人工氣道挽救了許多患者的生命, 但氣管插管和氣管切開操作及護理過程中會出現許多并發癥, 有些少見并發癥如氣管肉芽組織增生、氣管損傷后瘢痕狹窄、氣管軟化等所致的氣管狹窄易被忽視或誤診為其他疾病延誤治療, 機械通氣患者出現氣管肉芽組織增生、氣管損傷后瘢痕狹窄等常出現人機不協調, 呼吸困難、潮氣量低, 氣道狹窄嚴重的吸痰時吸痰管插入困難。氣管軟化患者拔出氣管插管或氣管切開套管后出現呼吸困難而危及生命。早期預防、及時發現、盡早處理可提高搶救成功率, 并可縮短住院時間、降低死亡率

引用本文： 張永利,萬獻堯,李素瑋. 建人工氣道患者氣管狹窄的病因分析及防治. 中國呼吸與危重監護雜志, 2009, 09(5): 503-504. doi: 復制

1.	Schuurmans MM, Michaud GC, Diacon AH, et al. Use of an Ultrathin Bronchoscope in the Assessment of Central Airway Obstruction. Chest, 2003, 124: 735-739.
2.	Boiselle PM, Ernst A. Recent Advances in Central Airway Imaging. Chest, 2002, 121: 1651-1660.
3.	Sun M, Ernst A, Boiselle PM. MDCT of the central airways-- Comparison with bronchoscopy in the evaluation of complications of endotracheal and tracheostomy tubes. J thorac imaging, 2007, 22: 136- 142.
4.	Krimsky WS, Sharief UU, Sterman DH. Topical Mitomycin C is an Effective, Adjunct Therapy for the Treatment of Severe, Recurrent Tracheal Stenosis in Adults. J Bronchol, 2006, 13: 141-143.
5.	Bodhey NK, Gupta AK, Neelakandhan KS, et al. Fluoroscopic-guided balloon dilatation and stenting in tracheal stenosis with metallic selfexpandable stents and long-term follow-up results. Australasian Radiology, 2007, 51: 351-357.
6.	Liu CC, Wang KM, Hsu LH. Tracheobronchial Self-expanding Metallic Stents in Patients With Central Airways Obstruction. J Bronchol, 2008, 15: 11-16.
7.	孫正良, 劉陽云, 馮秀榮, 等. 纖維喉鏡下微波治療喉氣管良性病變. 中國內鏡雜志, 2000, 6: 46.
8.	Yasuo M, Tanabe T, Tsushima K, et al. Endobronchial argon plasma coagulation for the management of post-intubation tracheal stenosis s. Respirology, 2006, 11: 659 -6628 .

1. Schuurmans MM, Michaud GC, Diacon AH, et al. Use of an Ultrathin Bronchoscope in the Assessment of Central Airway Obstruction. Chest, 2003, 124: 735-739.
2. Boiselle PM, Ernst A. Recent Advances in Central Airway Imaging. Chest, 2002, 121: 1651-1660.
3. Sun M, Ernst A, Boiselle PM. MDCT of the central airways-- Comparison with bronchoscopy in the evaluation of complications of endotracheal and tracheostomy tubes. J thorac imaging, 2007, 22: 136- 142.
4. Krimsky WS, Sharief UU, Sterman DH. Topical Mitomycin C is an Effective, Adjunct Therapy for the Treatment of Severe, Recurrent Tracheal Stenosis in Adults. J Bronchol, 2006, 13: 141-143.
5. Bodhey NK, Gupta AK, Neelakandhan KS, et al. Fluoroscopic-guided balloon dilatation and stenting in tracheal stenosis with metallic selfexpandable stents and long-term follow-up results. Australasian Radiology, 2007, 51: 351-357.
6. Liu CC, Wang KM, Hsu LH. Tracheobronchial Self-expanding Metallic Stents in Patients With Central Airways Obstruction. J Bronchol, 2008, 15: 11-16.
7. 孫正良, 劉陽云, 馮秀榮, 等. 纖維喉鏡下微波治療喉氣管良性病變. 中國內鏡雜志, 2000, 6: 46.
8. Yasuo M, Tanabe T, Tsushima K, et al. Endobronchial argon plasma coagulation for the management of post-intubation tracheal stenosis s. Respirology, 2006, 11: 659 -6628 .

《中國呼吸與危重監護雜志》

建人工氣道患者氣管狹窄的病因分析及防治

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《中國呼吸與危重監護雜志》

建人工氣道患者氣管狹窄的病因分析及防治

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