| Item type |
[ELS]学術雑誌論文 / Journal Article(1) |
| 公開日 |
2017-01-23 |
| タイトル |
|
|
タイトル |
ダッシュボード損傷による外傷性気管断裂の1例 |
|
言語 |
ja |
| タイトル |
|
|
タイトル |
A case of cervical tracheal injury following blunt neck trauma |
|
言語 |
en |
| 言語 |
|
|
言語 |
jpn |
| 資源タイプ |
|
|
資源タイプ識別子 |
http://purl.org/coar/resource_type/c_6501 |
|
資源タイプ |
journal article |
| 著者 |
宮地, 隆
宮地, 啓子
竹原, 延治
山田, 祥子
高橋, 治郎
堀田, 敏弘
井上, 貴博
椎野, 泰和
荻野, 隆光
MIYAJI, Takashi
MIYAJI, Keiko
TAKEHARA, Nobuharu
YAMADA, Sachiko
TAKAHASHI, Jiro
HOTTA, Toshihiro
INOUE, Takahiro
SHIINO, Yasukazu
OGINO, Ryukoh
|
| 著者所属(日) |
|
|
|
ja |
|
|
川崎医科大学救急医学 |
| 著者所属(日) |
|
|
|
ja |
|
|
川崎医科大学救急医学 |
| 著者所属(日) |
|
|
|
ja |
|
|
川崎医科大学救急医学 |
| 著者所属(日) |
|
|
|
ja |
|
|
川崎医科大学救急医学 |
| 著者所属(日) |
|
|
|
ja |
|
|
川崎医科大学救急医学 |
| 著者所属(日) |
|
|
|
ja |
|
|
川崎医科大学救急医学 |
| 著者所属(日) |
|
|
|
ja |
|
|
川崎医科大学救急医学 |
| 著者所属(日) |
|
|
|
ja |
|
|
川崎医科大学救急医学 |
| 著者所属(日) |
|
|
|
ja |
|
|
川崎医科大学救急医学 |
| 著者所属(英) |
|
|
|
en |
|
|
Department of Acute Medicine, Kawasaki Medical School |
| 著者所属(英) |
|
|
|
en |
|
|
Department of Acute Medicine, Kawasaki Medical School |
| 著者所属(英) |
|
|
|
en |
|
|
Department of Acute Medicine, Kawasaki Medical School |
| 著者所属(英) |
|
|
|
en |
|
|
Department of Acute Medicine, Kawasaki Medical School |
| 著者所属(英) |
|
|
|
en |
|
|
Department of Acute Medicine, Kawasaki Medical School |
| 著者所属(英) |
|
|
|
en |
|
|
Department of Acute Medicine, Kawasaki Medical School |
| 著者所属(英) |
|
|
|
en |
|
|
Department of Acute Medicine, Kawasaki Medical School |
| 著者所属(英) |
|
|
|
en |
|
|
Department of Acute Medicine, Kawasaki Medical School |
| 著者所属(英) |
|
|
|
en |
|
|
Department of Acute Medicine, Kawasaki Medical School |
| キーワード |
|
|
言語 |
ja |
|
主題Scheme |
Other |
|
主題 |
鈍的外傷 |
| キーワード |
|
|
言語 |
ja |
|
主題Scheme |
Other |
|
主題 |
頸部気管断裂 |
| キーワード |
|
|
言語 |
ja |
|
主題Scheme |
Other |
|
主題 |
受傷機転 |
| キーワード |
|
|
言語 |
ja |
|
主題Scheme |
Other |
|
主題 |
治療戦略 |
| キーワード |
|
|
言語 |
en |
|
主題Scheme |
Other |
|
主題 |
Blunt trauma |
| キーワード |
|
|
言語 |
en |
|
主題Scheme |
Other |
|
主題 |
Cervical tracheal injury |
| キーワード |
|
|
言語 |
en |
|
主題Scheme |
Other |
|
主題 |
Mechanism of injury |
| キーワード |
|
|
言語 |
en |
|
主題Scheme |
Other |
|
主題 |
Treatment strategy |
| 記事種別(日) |
|
|
内容記述タイプ |
Other |
|
内容記述 |
症例報告 |
|
言語 |
ja |
| 記事種別(英) |
|
|
内容記述タイプ |
Other |
|
内容記述 |
Case Report |
|
言語 |
en |
| 抄録(日) |
|
|
|
ja |
|
|
鈍的外傷に起因した頸部気管損傷は比較的稀な外傷であり,一般的に緊急で気道を確保しないと致命的である.今回,我々はダッシュボード損傷による頸部気管断裂をきたした重症外傷の1救命例を経験したので報告する.症例は21歳の女性.車の助手席に乗車中,交通事故にて受傷した.心肺停止状態で前医に搬送され蘇生処置に反応したために当院紹介となった.来院時JCS 300,バイタルサインは安定しており,診察上は前頚部に擦過傷を認めたのみであった.その際の画像検査で頸部気管断裂と診断されたが,気道開通は得られており換気可能であったために早急に気管再建術を施行しなかった.その後,待機的に気管切開術と気管断端処理を行い救命できた.本症例を経験し,力学的作用の面から受傷機転を考察するとともに,頸部気管断裂に対する治療戦略について文献的検討を加えて考察したので報告する. |
| 抄録(英) |
|
|
|
en |
|
|
Blunt cervical tracheal injury is a rare trauma. However, it is critical and frequently requires emergency airway management with surgical intervention, such as, emergency neck exploration and tracheostomy or reconstruction of the tracheal airway. This is an interesting and rare case of blunt cervical tracheal injury which was successfully managed with only oral tracheal intubation in the initial resuscitation. A 21-year-old female passenger suffered dashboard injury in the neck due to a head-on collision. At the scene of the accident, she was in cardiac arrest on arrival of the rescue team. She was then transported to a near-by emergency hospital with cardio-pulmonary resuscitation. At the hospital she was successfully resuscitated with an uneventful endotracheal intubation. Her vital signs were stabilized but she did not regain consciousness. Therefore she was referred to this hospital for further evaluation of life-threatening injuries and treatment of hypoxic brain damage due to prolonged cardio-pulmonary arrest time. On her arrival to this hospital, her airway was maintained without suspicion of tracheal injury. Although, there was minor abrasion over the anterior neck, there was no noticeable subcutaneous emphysema or suggested tracheal injury. Since she had suffered a high-impact automobile accident, a pan-scan of whole body was performed to rule out fatal life-threatening injuries in the torso. And it turned out that she had a cervical tracheal injury with dislodgment of the tip of an endotrahceal tube through the tracheal rupture into the soft tissue of anterior neck. The airway was maintained by a side hole of the endotracheal tube which enabled air exchange from the tube to distal trachea. This misplacement of the tip was confirmed by a bronchoscopy and the tip position was successfully corrected into distal trachea to the tracheal injury site. After the bronchoscopic procedure, ventilation was successfully maintained without any respiratory problems. Seven days after admission, neurological evaluation revealed that her persistent unconsciousness might have been due to post-resuscitation encephalopathy. Therefore it was feasible to do a permanent tracheostomy rather than reconstruction of the trachea. Finally, the mechanism of the cervical tracheal injury and strategy of staged treatments in this case was discussed with review of past articles. |
| 書誌情報 |
ja : 川崎医学会誌
en : Kawasaki medical journal
巻 42,
号 1,
p. 1-9,
発行日 2016
|
| URL |
|
|
識別子 |
http://igakkai.kms-igakkai.com/wp/wp-content/uploads/2016/KMJ-J42(1)1.pdf |
|
識別子タイプ |
URI |
| DOI |
|
|
|
識別子タイプ |
DOI |
|
|
関連識別子 |
https://doi.org/10.11482/KMJ-J42(1)1 |
| ISSN |
|
|
収録物識別子タイプ |
PISSN |
|
収録物識別子 |
0386-5924 |
| ISSN |
|
|
収録物識別子タイプ |
EISSN |
|
収録物識別子 |
2758-089X |
| 雑誌書誌ID |
|
|
収録物識別子タイプ |
NCID |
|
収録物識別子 |
AN00045593 |
| 雑誌書誌ID |
|
|
収録物識別子タイプ |
NCID |
|
収録物識別子 |
AN12940574 |
| 著者版フラグ |
|
|
出版タイプ |
VoR |
KJ00010237619.pdf (3.0 MB)
