METHODS: A 3-year-old boy fell from the seventh floor. Oxygenation worsened rapidly with pulse oxygen saturation decreasing below 60%, as his heart rate dropped. Persistent pneumothorax was observed with insertion of the chest tube. Fiberoptic bronchoscopy was performed, which confirmed the diagnosis of bronchial rupture. A modified tracheal tube was inserted under the guidance of a fiberoptic bronchoscope. Pulse oxygen saturation improved from 60% to 90%. Twelve days after admission, right upper lobectomy was performed using bronchial stump suture by video-assisted thoracic surgery without complications. A follow-up chest radiograph showed good recovery. The child was discharged from hospital three months after admission.
CONCLUSIONS: A modified tracheal tube could be selected to ensure a patent airway and adequate ventilation in patients with bronchial rupture.
方法:一个3岁男孩从七楼摔下来。氧合迅速恶化,脉搏血氧饱和度下降至60%以下,因为他的心率下降了.插入胸管观察到持续的气胸。进行了纤维支气管镜检查,证实了支气管破裂的诊断。在纤维支气管镜的引导下插入了改良的气管导管。脉搏血氧饱和度从60%提高到90%。入院后十二天,通过电视胸腔镜手术,使用支气管残端缝合术进行右上叶切除术,无并发症。随访胸部X光片显示恢复良好。患儿入院三个月后出院。
结论:可以选择改良的气管导管以确保支气管破裂患者的气道通畅和足够的通气。