插管后气管狭窄:2010 - 2022年的多中心研究

Mamadou Diawo Bah, Diop/Ndoye M, Outsouta Gn, G. I, Diaw M, L. Pa, Traoré Mm, Ndiaye Pi, Diouf E
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引用次数: 1

摘要

目的:探讨重症监护病房患者插管后气管狭窄的流行病学、临床、临床旁、治疗及演变情况。患者和方法:这是一项多中心、回顾性和描述性研究,于2010年11月1日至2022年6月1日在7个重症监护病房和3个耳鼻喉科进行。从医疗记录中,我们收集了流行病学数据(频率、年龄、性别)、病史、与气管插管相关的数据(指征、持续时间、插管管球囊膨胀压力)、插管后(PI)气管狭窄的数据(症状和发病时间)、临床旁数据、治疗和演变模式。收集到的数据以平均值及其标准差表示。结果:研究期间有19例患者出现PI气管狭窄。频率范围为0.03% ~ 0.1%。患者平均年龄25.7岁11.0714 ~ 38岁。47.37%的患者在创伤背景下插管。平均呼吸支持时间为10.37 d03.034-15 d未进行插管袖口压力监测。呼吸困难是主要的症状。平均发病时间33.21天12.071h-3个月。内镜下气管狭窄平均程度为72.63%50-99%。治疗方面,在重症监护中,5例(26.31%)出现急性呼吸衰竭的患者接受了挽救生命的气管切开术。根治性手术包括气管切除吻合(73.68%)和气管扩大成形术(26.32%)。9例(47.37%)患者预后良好。术后狭窄复发率为31.58%。死亡3例(15.79%)。结论:插管袖口过度膨胀是导致PI气管狭窄的主要原因。预防的基础是系统地监测其通胀压力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Post-Intubation Tracheal Stenosis: Multicenter Study from 2010 to 2022
Objective: To study the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of post-intubation tracheal stenosis occurring in patients admitted to intensive care units. Patients and methods: This is a multicenter, retrospective and descriptive study conducted from November 1, 2010 to June 1, 2022 in 7 intensive care units and 3 ENT departments. From medical records, we collected epidemiological data (frequency, age, sex), medical history, data relating to tracheal intubation (indication, duration, inflation pressure of the intubation tube balloon), data on post-intubation (PI) tracheal stenosis (symptoms and time to onset), paraclinical data, treatment and evolution modalities. The data collected were expressed as averages with their standard deviation. Results: During the study period, 19 patients presented with PI tracheal stenosis. The frequency ranged from 0.03% to 0.1%. The average age of the patients was 25.7 years 11.07 14-38 years. Patients had been intubated in a traumatic context in 47.37% of cases. The average duration of ventilatory support was 10.37 days  03.03 4-15 days No intubation tube cuff pressure monitoring was done for any patient. Dyspnea was the main telltale sign. Its average time to onset was 33.21  days 12.07 1h-3months. Endoscopically, the average degree of tracheal stenosis was 72.63% 50-99% . Therapeutically, in intensive care, 5 patients (26.31%) who presented with acute respiratory failure underwent a life-saving surgical tracheostomy. Curative surgery resulted in a tracheal resection-anastomosis (73.68%) and enlargement tracheoplasty (26.32%). The outcome was favorable for 9 patients (47.37%). The recurrence of the stenosis after curative surgery was observed in 31.58% of cases. Death occured in 3 patients (15.79%). Conclusion: Over-inflation of the intubation tube cuff is the leading cause of PI tracheal stenosis. Prevention is based on the systematic monitoring of its inflation pressure.
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