氣管截除及端對端吻合術治療氣管狹窄－病例報告

Resection and End-to-End Anastomosis for Tracheal Stenosis – Case Report

張哲銘(Jer-Ming Chang) ； 林曜祥(Yaoh-Shiang Lin) ； 王興萬(Hsing-Won Wang) ； 蘇文勇(Wen-Yung Su)

《中華民國耳鼻喉科醫學雜誌》 34卷4期 (1999/07) Pp. 343-346

https://doi.org/10.6286/1999.34.4.343

摘要

形成氣管狹窄的大部份原因，是因為長期不當的氣管插管或氣管造口術而導致氣管黏膜及軟骨損傷，進而造成環狀疤痕增生或軟骨結構的軟化，使得氣管管徑逐漸變小，甚至完全阻塞。本院經歷一21歲男性，在入院前6個月因車禍造成顱內出血，在他院治療期間，由於長期氣管造口及氣管內管照護不良，形成氣管狹窄，雖經雷射手術後，自環狀軟骨以下第5氣管軟骨間依舊完全阻塞，軟骨結構完全消失。轉至本院後接受氣管截除及端對端吻合術。術後恢復正常口鼻呼吸及語言功能，出院後於門診追蹤至今情況良好。

關鍵字

氣管截除 ； 吻合術

並列摘要

Tracheal stenosis is usually the result of an improperly performed tracheostomy or an intubation injury. Injuries at the tracheostomy site, the cuff, or the tip of the tracheostomy tube might result in cicatricial healing, granulation tissue formation, and loss of cartilaginous structural support. Tracheal resection with anastomosis is a feasible means for managing Grade IV stenosis when medical management fails. We present a case of tracheal stenosis from the lower cricoid to the tracheal stoma which developed after long term intubation. The 21-year-old patient underwent tracheal resection with end-to-end anastomosis and laryngeal release. A 4 cm long stenotic segment was resected using a muscle mobilization method. The nasal endotracheal tube was removed 6 days after surgery and the wound healed well. The patient has been followed for more than 1 year in the outpatient clinic without recurrent stenosis.

並列關鍵字

tracheal resection ； anastomosis