Interventional Bronchoscopy Using Flexible Bronchoscope and Metallic Stent without Fluoroscopy to Liberate a Patient from Acute Respiratory Failure Due to Esophageal Cancer-Related Tracheal Invasion-A Case Report

在無放射線透視下使用軟式支氣管鏡及金屬支架讓食道癌併氣管侵犯呼吸衰竭的病人脫離呼吸器－病例報告

葉政男(Cheng-Nan Yeh) ； 陳鴻仁(Hung-Jen Chen) ； 陳家弘(Chia-Hung Chen) ； 涂智彥(Chih-Yen Tu) ； 夏德椿(Te-Chun Hsia) ； 施純明(Chuen-Ming Shih)

《胸腔醫學》 26卷2期 (2011/04) Pp. 108-113

https://doi.org/10.29806/TM.201104.0008

摘要

食道癌併發呼吸道的侵犯可以造成上呼道的阻塞。而急性呼吸衰竭是上呼道阻塞最嚴重的併發症之上。在上呼吸道阻塞導致呼吸衰竭的病人，介入性支氣管鏡合併可自行擴張的金屬支架置入可加速病人脫離呼吸器。我們報告一種修改過的方式，讓一位因食道癌併上呼吸道阻塞導致急性呼吸衰竭且插了6.5 mm氣管內管的病人，成功的脫離了呼吸器。我們使用軟式支氣管鏡而不經由6.5 mm氣管內管的方式置入Ultrflex薄膜覆蓋式支架，經治療後病人很快的就脫離呼吸器。

關鍵字

食道癌 ； 呼吸衰竭 ； 呼吸器 ； Ultraflex

並列摘要

Esophageal cancer with airway invasion can cause central airway obstruction. Acute respiratory failure is 1 of the most severe complications of patients with central airway obstruction, and in these patients, interventional bronchoscopic procedures with implantation of self-expandable metallic stents (SEMSs) can facilitate weaning from mechanical ventilation. We describe a modified method that was used to successfully liberate an esophageal cancer patient who was intubated with a 6.5-mm endotracheal tube (ETT) and who was ventilator-dependent due to advanced esophageal cancer-related central airway obstruction. We implanted an Ultraflex covered stent using a flexible bronchoscope without insertion through the 6.5-mm ETT and the patient was weaned from the ventilator shortly after the procedure.

並列關鍵字

esophageal cancer ； respiratory failure ； mechanical ventilation ； Ultraflex