[气管支气管创伤的处理]。

Q4 Medicine Kyobu geka. The Japanese journal of thoracic surgery Pub Date : 2024-04-01
Kazuhisa Tanaka, Hidemi Suzuki, Ichiro Yoshino
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引用次数: 0

摘要

背景:钝器创伤导致的气管支气管损伤在胸部损伤中相对罕见。但是,如果处理不当,这些损伤可能是致命的。预后与精确的诊断和治疗密切相关。我们在此报告三例需要手术治疗的气管支气管外伤病例。病例 1:一名 17 岁的男性因躯干被重型机械缠住而受伤。诊断结果显示右主支气管撕裂,需要用左单肺通气进行转运。患者接受了气管支气管重建治疗。病例 2:一名 71 岁的男性因汽车与电线杆相撞而遭受外伤。由于气管膜区撕裂,他在气管插管后被送往医院。受伤部位已缝合。病例 3:一名被火车撞伤的 17 岁女性出现急性呼吸衰竭,插管后被送往医院。因氧合不良而启动了静脉体外膜氧合(VV-ECMO)。观察到右侧中间支气管干完全破裂,右侧主支气管膜撕裂,于是进行了支气管成形术:结论:迅速、准确的诊断,加上及时、明智的治疗干预,在处理气管和支气管损伤中起着至关重要的作用。
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[Management of Tracheobronchial Injuries due to Brunt Trauma].

Background: Tracheobronchial injuries resulting from blunt trauma are relatively rare among chest injuries. However, if these injuries are not managed properly, they can be fatal. The prognosis is intricately linked to the precise diagnosis and treatment. We herein report three cases of tracheobronchial trauma that required surgical intervention. Case 1:A 17-year-old male sustained injuries when his torso became entangled in heavy machinery. The diagnosis revealed a tear in the right main bronchus, which required transportation with left single- lung ventilation. The patient was treated by tracheobronchial reconstruction. Case 2:A 71-year-old male experienced trauma when his car collided with a utility pole. He was transported to the hospital after tracheal intubation due to a laceration of the tracheal membranous area. The site of the injury was closed with sutures. Case 3:A 17-year-old female who had been struck by a train suffered acute respiratory failure and was transported to the hospital after intubation. Veno-venous extracorporeal membrane oxgenation (VV-ECMO) was initiated in response to poor oxygenation. Complete rupture of the right middle bronchial trunk and laceration of the right main bronchial membrane were observed, and bronchoplasty was performed.

Conclusion: A swift and accurate diagnosis, coupled with timely and judicious therapeutic interventions, play a pivotal role in managing tracheal and bronchial injuries.

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