Occurrence of subglottic tracheal stenosis after tracheotomy in patients with cicatricial diathesis

E. Chang, X. Ruan, Ningtao Li, Mingyang Sun, Shengli Zhou, Jiaqiang Zhang
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Abstract

Objective To investigate the occurrence of subglottic tracheal stenosis after tracheotomy in the patients with cicatricial diathesis. Methods From May 2012 to May 2017, the tracheotomized patients in intensive care unit who were readmitted for airway therapy were selected.Patients with subglottic tracheal stenosis were assigned to cicatricial diathesis group and non-cicatricial diathesis group.Samples of tracheal stenosis were obtained for routine pathological examination, and the results were recorded.The degree of tracheal stenosis was classified according to the Myer-Cotton grade.The time of bearing a tracheal cannula and time of subglottic trachea stenosis were recorded, and the therapeutic effect was also recorded. Results A total of 2 276 racheotomized patients (139 with cicatricial diathesis and 2 137 with non-cicatricial diathesis) were included in this study, the incidence of subglottic tracheal stenosis was 2.90%, and the incidence of subglottic tracheal stenosis was significantly higher in patients with cicatricial diathesis than in those with non-cicatricial diathesis (P<0.01). Compared with non-cicatricial diathesis group, the Myer-Cotton grade was significantly increased, the time of subglottic tracheal stenosis occurred was shortened, the treatment times were increased, the rate of effective treatment was decreased, and the scar formation rate was increased in cicatricial diathesis group (P<0.01). Conclusion Patients with cicatricial diathesis are more likely to develop subglottic tracheal stenosis after tracheotomy, with severe degree and poor treatment effect. Key words: Tracheal stenosis; Keloid; Tracheostomy
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瘢痕素质患者气管切开术后声门下气管狭窄的发生
目的探讨瘢痕素质患者气管切开术后声门下气管狭窄的发生情况。方法选择2012年5月至2017年5月在重症监护室再次入院接受气道治疗的气管切开患者。将声门下气管狭窄患者分为瘢痕素质组和非瘢痕素质组。取气管狭窄标本进行常规病理检查,并记录结果。根据Myer-Cotton分级对气管狭窄程度进行分类。记录气管插管时间和声门下气管狭窄时间,并记录治疗效果。结果共有2 276例气管切开患者(139例为瘢痕性素质,2 137例为非瘢痕性素质)声门下气管狭窄发生率为2.90%,瘢痕素质组声门下气管狭窄的发生率明显高于非瘢痕素质组(P<0.01),结论瘢痕素质组气管切开术后更易发生声门下气管狭窄,程度严重,治疗效果差。关键词:气管狭窄;Keloid;气管造口术
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中华麻醉学杂志
中华麻醉学杂志 Medicine-Anesthesiology and Pain Medicine
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