Common causes and countermeasures of tracheal posterior wall injury during tracheotomy
10.3969/j.issn.1008-9691.2024.04.020
- VernacularTitle:气管切开术中气管后壁损伤的常见原因及处理措施
- Author:
Daiyu SONG
1
;
Xiumin REN
Author Information
1. 河北医科大学第二医院耳鼻咽喉科,河北 石家庄 050000
- Keywords:
Tracheotomy;
Tracheal posterior wall injury;
Common cause;
Countermeasure
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(4):482-484
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the common causes and countermeasures of tracheal posterior wall injury during tracheotomy.Methods Clinical data of 12 critically ill patients with posterior tracheal wall injury during tracheotomy admitted to the Second Hospital of Hebei Medical University from February 2022 to March 2024 were retrospectively analyzed,and the common causes and countermeasures were discussed.Results A total of 12 patients were intubated through the mouth to tracheostomy for 18-40 days,with an average of(31.54±4.52)days;the pressure of the cuff before tracheostomy was measured as 37-54 cmH2O(1 cmH2O≈0.098 kPa),with an average of(42.34±5.23)cmH2O.The 3 clinical countermeasures oral intubation,anastomotic intubation close to the anterior tracheal wall and fiberbronchoscope-guided intubation played an important role in the occurrence of intraoperative complications.Wound bleeding occurred in 2 patients after operation,vaseline gauze was given to fill the wound,and the bleeding symptoms stopped after 3 days.Subcutaneous emphysema occurred in 2 patients after operation,and all of them disappeared spontaneously after 5-7 days.Pneumothorax was found in 1 case by CT examination 1 day after operation,and the symptoms were relieved 5 days later by closed thoracic drainage,and no patient died from this complication.Conclusions Excessive intubation time before tracheotomy and excessive tracheal cuff pressure are the main common causes of intraoperative injury to the posterior tracheal wall.Three clinical countermeasures can solve these complications in a short time and save patients'lives.Compared with the other two measures,fiberbronchoscope-guided intubation can minimize the occurrence of postoperative complications in patients.
