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Abstract：
OBJECTIVE: Tracheo-innominate artery fistula (TIF) is a rare but life-threatening complication following tracheostomy or tracheoesophageal diversion (TED). Although successful surgical intervention for TIF has been reported, few studies have been performed in patients with severe motor and intellectual disability (SMID). Therefore, we aimed to analyze TIF in patients with SMID to clarify the clinical variables predicting the occurrence and adequate management for lifesaving of TIF.
METHODS: We retrospectively reviewed the records of patients with SMID undergoing surgical tracheostomy and TED between 2006 and 2012 and identified those with TIF. When TIF occurred, we obtained the clinical status and emergency management.
RESULTS: Of 70 patients who underwent tracheostomy or TED during the study period, three patients had TIFs; in one case, TIF was avoided by ligation of the innominate artery before TED. The incidence of TIF in those undergoing tracheostomy and TED was 2.3% and 7.4%, respectively. The interval between tracheostomy and TIF was 14-50 months.
CONCLUSIONS: Patients with SMID may have an increased risk of TIF. Prompt diagnosis and surgical intervention to control the bleeding is the only effective management at present.
METHODS: We retrospectively reviewed the records of patients with SMID undergoing surgical tracheostomy and TED between 2006 and 2012 and identified those with TIF. When TIF occurred, we obtained the clinical status and emergency management.
RESULTS: Of 70 patients who underwent tracheostomy or TED during the study period, three patients had TIFs; in one case, TIF was avoided by ligation of the innominate artery before TED. The incidence of TIF in those undergoing tracheostomy and TED was 2.3% and 7.4%, respectively. The interval between tracheostomy and TIF was 14-50 months.
CONCLUSIONS: Patients with SMID may have an increased risk of TIF. Prompt diagnosis and surgical intervention to control the bleeding is the only effective management at present.
摘要：
目的：气管切开或气管食管改道（TED）后，气管无名动脉瘘（TIF）是一种罕见但危及生命的并发症。尽管已经报道了成功的TIF手术干预，在重度运动和智力残疾(SMID)患者中进行的研究很少.因此,我们旨在分析SMID患者的TIF,以阐明预测TIF发生的临床变量以及为挽救TIF的生命而采取的适当管理.
方法：我们回顾性回顾了2006年至2012年间接受外科气管切开术和TED的SMID患者的记录，并确定了TIF患者。当TIF发生时,我们获得了临床状态和急诊处理。
结果：在研究期间接受气管切开术或TED的70名患者中，三名患者患有TIF；在一个病例中，在TED之前通过结扎无名动脉来避免TIF。TIF在接受气管切开术和TED的患者中的发生率为2.3％和7.4％，分别。气管造口术和TIF之间的间隔为14-50个月。
结论：SMID患者发生TIF的风险增加。及时诊断和手术干预以控制出血是目前唯一有效的治疗方法。
方法：我们回顾性回顾了2006年至2012年间接受外科气管切开术和TED的SMID患者的记录，并确定了TIF患者。当TIF发生时,我们获得了临床状态和急诊处理。
结果：在研究期间接受气管切开术或TED的70名患者中，三名患者患有TIF；在一个病例中，在TED之前通过结扎无名动脉来避免TIF。TIF在接受气管切开术和TED的患者中的发生率为2.3％和7.4％，分别。气管造口术和TIF之间的间隔为14-50个月。
结论：SMID患者发生TIF的风险增加。及时诊断和手术干预以控制出血是目前唯一有效的治疗方法。
