罕見的成人氣道異物－脫落之氣管內管

Unusual Airway Foreign Body in an Adult-A Dislodged Endotracheal Tube

林慶宗(Ching-Tzung Lin) ； 楊政謙(Cheng-Chien Yang) ； 黃志銘(Chin-Ming Huang) ； 李國森(Kuo-Sheng Lee)

《台灣耳鼻喉頭頸外科雜誌》 41卷1期 (2006/02) Pp. 42-45

https://doi.org/10.6286/2006.41.1.42

摘要

成人大部分的氣管、支氣管異物可經由傳統的設備，如硬式支氣管鏡或軟式纖維支氣管鏡，搭配各種異物鉗取出。取出異物的路徑通常是經由鼻腔，口腔或是氣管切開造口。本文報告一例口腔癌患者接受過手術及放射治療後，氣管插管滑脫入氣管。由於患者接受口腔及頭頸部手術，因此解剖構造異常，增加了手術取出的困難度。特提出異物取出的過程並回顧文獻中氣管異物取出的方法。

關鍵字

氣管 ； 異物 ； 異物鉗

並列摘要

Conventional instruments, such as video-assisted rigid ventilation bronchoscope with various designs of forceps, or fiberoptic bronchoscopes are able to remove most aspirated foreign bodies. The common insertional routes for such instruments are oral cavity for rigid scopes and the nasal cavity or through an endotracheal tube for fiberoptic endoscopes. The use of tracheostomy as a route for bronchoscopic retrieval of foreign bodies has been reported when the bronchoscope fails to work via the mouth due to an edematous larynx or other obstructive lesions in the upper airway.
We reported here an adult with oral cancer who had undergone major operations, chemotherapy, radiotherapy and temporary tracheostomy. A rare large foreign body was found to be lodged into the trachea. Customary instruments failed to remove the foreign body. Finally, under the assistance of a videofiberoptic endoscopy, we were able to remove the foreign body, an endotracheal tube, using 45-degree forceps that are normally used in endoscopic sinus surgery.

並列關鍵字

trachea ； foreign body ； foreign body forceps