TRACHEO-INNOMINATE ARTERY EROSION - SUCCESSFUL SURGICAL MANAGEMENT OF A DEVASTATING COMPLICATION
TRACHEO-INNOMINATE ARTERY EROSION - SUCCESSFUL SURGICAL MANAGEMENT OF A DEVASTATING COMPLICATION
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DOI：
10.1097/00000658-197608000-00011
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发表时间：
1976-01-01
影响因子：
9
通讯作者：
DRAPANAS, T
中科院分区：
文献类型：
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作者：
JONES, JW;REYNOLDS, M;DRAPANAS, T
气管无名动脉糜烂的成功治疗需要迅速制定具体的复苏和手术措施。在新奥尔良路易斯安那州慈善医院的10例患者和127例来自世界文献的记录病例进行了分析，包括诱发因素，诊断特征，复苏措施和手术治疗。在48%的气管无名糜烂患者中发现与颈部位置异常相关的诊断。在96例病例中，69%的侵蚀部位位于套管末端，并涉及过度的前向压力。对于颈部位置异常、气管造口位置较低和体质虚弱的患者，建议谨慎使用。当气管气囊膨胀或胸骨后指压法时，复苏措施非常成功。所有为气管造口患者提供护理的人员应了解球囊充气的初始测量值。在将来可能发生糜烂的区域永久性中断无名动脉的手术措施是最成功的。在22例无名动脉被处死的病例中，只有1例有脑缺血的证据。及时采取适当的措施，可以挽救意外数量的这些戏剧性的死亡。图像
Successful management of a patient with tracheo-innominate artery erosion requires the rapid institution of specific resuscitative and operative measures. Ten patients seen at the Charity Hospital of Louisiana in New Orleans and 127 documented cases from the world literature were analyzed regarding predisposing factors, diagnostic features, resuscitative measures and operative treatment. Diagnoses associated with abnormal neck positioning were seen in 48% of patients with tracheo-innominate erosions. In 69% of 96 instances, the site of erosion was located at the cannula end and implicates excessive anterior pressure. Caution is recommended in those patients with abnormal neck positions, low placed tracheostomy stomas and individuals with asthenic habitus. Resuscitative measures were highly successful when the tracheal ballon was inflated or when the method of retrosternal finger pressure was used. All personnel providing care for patients with tracheostomies should be aware of the initial measure of ballon inflation. Operative measures which permanently interrupted the innominate artery in the area of possible future erosion were the most successful. Of the 22 cases in which the innominate artery was sacrificed, only one had evidence of cerebral ischemia. Timely institution of proper measures can result in salvage of an unexpected number of these otherwise dramatic fatalities. Images