Bronchial stenosis

Introduction Tracheobronchial stenosis is caused by airway obstruction causing shortness of breath and difficulty in breathing. When physical activity and respiratory secretions increase, it is often aggravated. Patients with previous tracheotomy and intubation who present the above symptoms should first consider tracheal scar stenosis. The anterior, lateral, and oblique tracheal tomograms clearly show the location, extent, length, and morphological changes of the stenosis.

Cause

This disease is common in tracheotomy, when the tracheotomy site is too high, damage the first cartilage ring, can lead to ring cartilage erosion, inflammatory lesions and difficult to repair the ring of subchondral severe stenosis. When the tracheotomy is performed, excessive anterior wall tissue of the trachea is removed, and a large amount of granulation tissue and fibrous scar tissue can be formed in the future. The tracheal tube compresses the anterior wall of the trachea, causing the tissue to collapse inwardly above the incision and the tube connected outside the tracheal tube to overstress the tracheal wall, causing the tissue to be crushed and eroded, and fibrous scar tissue can be formed in the future.

In addition, the extra-ventilation of the tracheal tube used to close the tracheal tube is too high, and it can also compress the tracheal wall for the whole week, causing tissue erosion and necrosis. In severe cases, annular scarring is formed in the future, or tracheal esophageal fistula and trachea are unknown. Arterial spasm. In the latter two cases, the mortality rate is high. Therefore, the tracheotomy and intubation should be paid attention to the tracheotomy site, the anterior wall tissue should be removed too much, the size and length of the tracheal tube should be appropriate, the inflation pressure of the balloon should not be too high, and the connected pipeline should be light. Soft to reduce the incidence of complications of tracheal stenosis.

Tracheal incision and tracheal stenosis after intubation

(1) high incision causes stenosis

(2) stenosis of the balloon

(3) tracheal incision stenosis and balloon

(4) tracheal stenosis and tracheoesophageal fistula

(5) The tracheal wall is softened and inflammatory between the trachea and the right innominate artery.

an examination

Related inspection

Chest bronchography

Medical history

Benign tumors of the trachea (including squamous cell papilloma, osteochondroma, lipoma, hemangioma, fibroid, and leiomyoma) and malignant tumors (squamous cell carcinoma, adenoid cystic carcinoma), mostly misdiagnosed as "asthma "And a history of atelectasis.

2. Signs

It can smell and wheezing, or it can smell low on the side of the lungs.

3. Auxiliary inspection

1x line check. Chest x-ray, tracheal tomography can be seen in the tracheal mass shadow.

2ct scan check. The location of the tracheal tumor, the size of the tumor, and the relationship between the tumor and the surrounding tissue can be seen.

3 fiberoptic bronchoscopy. The location and size of the lesion can be determined and a biopsy can be performed.

Differential diagnosis

To distinguish from bronchitis and bronchial asthma, atelectasis. Asthma often occurs suddenly in childhood or youth, and generally has no history of chronic cough and cough, characterized by paroxysmal asthma. Both lungs are full of wheezing during the attack, and can be asymptomatic after remission. There is often a history of personal or family allergic diseases. Wheezing chronic bronchitis is more common in middle and old age. Cough, cough accompanied by wheezing and wheezing are the main clinical manifestations. Symptoms can be relieved after infection control, but wheezing can be heard in the lungs.

Chronic bronchitis occurs in the elderly, but people with weakened body or frequent exposure to certain irritating substances such as chemical gases, smoking, dust and viruses, bacterial infections and other factors can cause chronic bronchitis. On the basis of chronic bronchitis, asthma bronchitis can be developed, and on the basis of bronchial asthma, chronic bronchitis can be complicated. Lung insufficiency refers to a state of contraction and no gas in the whole lung or part of the lung. Lack of atelectasis may be acute or chronic, and there are often lung-free, infection, bronchiectasis, tissue destruction and fibrosis in chronic atelectasis lesions.

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