老年气管切开置管并发气管食管瘘  

CLINICAL ANALYSIS OF 9 ELDERLY PATIENTS WITH TRACHEOESOPHAGEAL FISTULA AND INTUBATION AFTER TRACHEOTOMY

作　　者：司徒慧如[1] 王沁[1] 吕吉[1] 朱文娟[1] 

机构地区：[1]华东医院耳鼻咽喉科,上海市200040

出　　处：《老年医学与保健》2005年第1期44-45,共2页Geriatrics & Health Care

摘　　要：目的探讨老年患者气管切开置管并发气管食管瘘的原因及诊治方法。方法对9例老年气管切开置管并发气管食管瘘的临床资料进行回顾性分析。结果本组病例从套管留置到确诊气管食管瘘的时间平均为30.2±17.9天;临床表现主要有发作性成人呼吸窘迫症(3例),吸入性肺炎(3例);经套管中吸出胃内容物确诊4例,经纤维支气管镜确诊2例,2例误诊为慢性支气管炎,后经胃镜确诊;6例胃管鼻饲饮食,1例行胃造瘘术,1例行胃造瘘+空肠造瘘术;随访3个月,6例死亡。结论老年患者气管切开置管并发气管食管瘘与老年生理特点及疾病因素有关,死亡率高,临床表现缺乏典型性,应积极预防,及时诊断,避免误诊,以适宜的治疗为主。Objection To explore the causes, diagnosis and treatment of tracheoesophageal fistula with intubation after trache- otomy in aged patients. Methods Clinic data of 9 cases were retrospectively analysed. Results The mean time of which the fistula occurring from tracheotomy was 30.2±17.9 days;3 cases presented with paroxysm of Adult respiratory distress syndrome(ARDS),3 cases with aspiratory pneumonia;The diagnosis was confirmed by exsuction of food from the tracheal tube in 4 cases,fiberoptic bronchoscopy in 2 cases,2 cases had been misdiagnosed as chronic bronchitis and were confirmed by gastroscopy;Gastrogavage were performed in 6 cases,gastrostomy in 1 case and jejunostomy+gastrostomy in 1 case; All patients were followed up for 3 months and 6 died. Conclusions Tracheoesophageal fistula is associated with elderly physiological features and original diseases, the mortality is high,the clinical manifestation has no typical features the prevention, proper diagnosis and suitable therapy should be given.

关 键 词：老年人 气管切开术 气管食管瘘 

分 类 号：R653[医药卫生—外科学] R562.13[医药卫生—临床医学]