气管扩张致气管插管漏气1例  

Tracheal intubation leakage caused by tracheal dilation:a case report

作　　者：陈培章 石翊飒[1] 李雅楠[1] Chen Peizhang;Shi Yisa;Li Ya'nan(Department of Anesthesiology,Lanzhou University Second Hospital,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院麻醉科,兰州730030

出　　处：《国际麻醉学与复苏杂志》2022年第11期1185-1187,共3页International Journal of Anesthesiology and Resuscitation

摘　　要：气管支气管巨大症(tracheobronchomegaly,TBM)为罕见病,多因肺部感染就诊发现,胸部数字X线摄影(digital radiography,DR)或CT检查见气管和(或)支气管管径异常不均匀增宽,气管镜检查亦可确诊本病。无症状患者行非胸部手术时往往不做胸部详细检查,这将导致此类患者漏诊,全麻后常规气管导管可能会无法有效堵塞增粗软化的气管,这给麻醉带来风险。此病例在患者术前麻醉访视时未发现合并TBM,麻醉后行常规气管插管发现漏气严重,多次调整气管插管置入深度后最终有效堵塞气道并进行机械通气。总结此病例资料以期为麻醉医师提供警示和参考。Tracheobronchomegaly(TBM)is a rare disease,which is often diagnosed due to lung infection,with abnormal broad⁃ening in the diameter of the trachea and(or)bronchial tube by digital radiography(DR)plain film or computer tomography(CT)exami⁃nation,and can be diagnosed by bronchoscopy.Asymptomatic patients undergoing non⁃thoracic surgery usually do not have such a de⁃tailed chest examination,which may lead to missed diagnosis in these patients.After general anesthesia,the thickening and softening of the trachea makes it impossible for conventional tracheal tubes to plug effectively,that will increase risk to anesthesia.In the current study,TBM was not founded in the patient's preoperative visit.It was observed that air leakage in routine endotracheal intubation after anesthesia,the depth of endotracheal catheter placement was adjusted for many times,and finally the airway was effectively blocked and mechanically controlled ventilation was carried out smoothly.This case is expected to provide warning and reference for anesthesi⁃ologists.

关 键 词：气管支气管巨大症 气管插管 麻醉 全身 

分 类 号：R614[医药卫生—麻醉学]