Successful Conservative Treatment for a Large Tracheal Laceration Caused by Endotracheal Cuff Overinflation

氣管裂傷是氣管內插管的一個少見但嚴重的併發症，外科修補是氣管裂傷的主要處理方式。我們報告的病例是一個70歲的女性因為急性心肌梗塞合併肺水腫及呼吸衰竭而接受氣管內管插管，剛住院的胸部X光片呈現過度充氣的氣管內管氣囊，在住院的12小時後病人出現皮下氣腫的情形。緊急的軟式支氣管鏡檢查發現在氣管的中下方後壁有一個長6公分寬1.5公分的大型氣管裂傷。由於外科修補不可行，因此嘗試保守治療．第28天後，氣管鏡追蹤發現之前的氣管裂傷已癒合。病人隨後脫離呼吸器並且出院。大型的氣管裂傷經保守治療後癒合在文獻回顧上是很罕見的。我們報告這個治療成功的病例，並且回顧過去因氣管內插管所導致氣管裂傷的相關文獻。

關鍵字

氣管裂傷；氣管內管插管；氣囊過度充氣；保守治療

並列摘要

Tracheal laceration is a rare but severe complication of endotracheal intubation, and surgical repair remains the primary treatment. We report the case of a 70-year-old female who had been admitted because of acute myocardial infarction associated with acute pulmonary edema and respiratory failure with endotracheal intubation. Cuff overinflation was noted on the chest X-ray film initially, and then subcutaneous emphysema developed 12 hours after admission. Emergency fiberoptic bronchoscopy revealed a large laceration in the posterior wall of the middle and lower trachea. Surgical repair was not feasible and conservative treatment was tried. The laceration healed after 28 days. The patient was weaned from the ventilator and then discharged. Spontaneous healing of a large tracheal laceration after conservative treatment is rarely found in the literature.

並列關鍵字

tracheal laceration ； endotracheal intubation ； cuff overinflation ； conservative treatment

國際替代計量

Successful Conservative Treatment for a Large Tracheal Laceration Caused by Endotracheal Cuff Overinflation

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