Tracheal obstruction

Introduction Patients with tracheal obstruction have varying degrees of dyspnea and hypoxemia, and even respiratory failure. People with foreign body in the respiratory tract often present with sudden dyspnea, and those caused by extra-respiratory factors are often chronic dyspnea. The respiratory tract is divided into two parts, the upper and lower respiratory tract, by the lower edge of the annular cartilage. The upper respiratory tract consists of the nose, sinuses, and throat. The principle of treatment of acute airway obstruction, in addition to sedation, oxygen should be treated as an etiology and symptomatic treatment.

Cause

When foreign bodies or tumors grow up and block the tracheal cavity more than 50%, shortness of breath, difficulty in breathing, wheezing, etc., are often misdiagnosed as bronchial asthma and delay treatment. Bronchial obstruction may be caused by intraluminal mass, foreign body, congenital stenosis, secretion stagnation, edema, blood clot and sputum contraction, etc., or due to external compression, such as tumors, enlarged lymph nodes. Partial obstruction causes obstructive emphysema; complete obstruction causes obstructive atelectasis.

an examination

Related inspection

Tracheal aspiration bronchography

Blow test, chest radiograph, etc. can be diagnosed.

Such as chest fluoroscopy and chest radiographs, no matter the ortho and lateral position, it is difficult to find intratracheal lesions. The simplest and most effective is the anterior and posterior position of the tracheal layer, and the tracheal bifurcation. It is sometimes difficult to judge small lesions.

Tracheal lipiodol angiography is of great significance for the diagnosis of tracheal tumors, which can clearly show the lesions and contours. However, due to the pain of the examination, there is also the risk of suffocation when the lumen is obstructed obviously, so it has been used less recently.

Endoscopy can directly observe the surface structure of the lesion, and can also obtain the diseased tissue, which can be used for pathological cytological diagnosis and provide important information for treatment. In particular, fiber optic endoscope technology has recently been used, and patients are easily examined. However, endoscopic biopsy is difficult to obtain tissue for hard chondromas and hamartomas, and tumors covered with necrotic tissue or normal mucosa are also difficult to obtain pathological cytological diagnosis.

Such as the pathological morphology and growth characteristics of the tracheal tumor mentioned above, it is helpful to diagnose benign and malignant, but if the pathological cytological diagnosis is not biopsy, it is sometimes difficult to identify benign and malignant.

Differential diagnosis

Patients with tracheal obstruction have varying degrees of dyspnea and hypoxemia, and even respiratory failure.

The clinical symptoms of tracheal tumors vary according to the size and nature of the tumor. Common early symptoms are irritating cough, spasm or innocence, and sometimes bloodshot. When the tumor grows and blocks the tracheal cavity more than 50%, there are shortness of breath, difficulty in breathing, wheezing, etc., which are often misdiagnosed as bronchial asthma and delay treatment. Late cases of tracheal malignancies may present with hoarseness, difficulty swallowing, tracheoesophageal fistula, compression of mediastinal organs, cervical lymph node metastasis, and pulmonary purulent infection.

Tracheal foreign body: The patient has sudden cough, severe cough and suffocation, and may have asthma, hoarseness, purpura and difficulty breathing. If it is a small and smooth active foreign body, such as melon seeds, corn kernels, etc., when the patient coughs, he can hear the slap sound of the foreign object hitting the glottis, and the hand can be vibrated in front of the larynx. If the foreign body is large, blocking the trachea or close to the protuberance of the tracheal branch, the ventilation of the main bronchus on both sides may be seriously impeded, so severe breathing difficulties, even suffocation and death may occur.

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