[Management strategies of granulation in tracheal post-tracheostomy caused by prolonged mechanical ventilation].

Objective

To analyze the effect and safety of treatment in patients with airway stenosis caused by tracheotomy for mechanical ventilation. Method: We treated the patients with airway stenosis caused by granulation tissue. The patients with grade Ⅰ,Ⅱ airway stenosis were treated with adjustable flange tracheostomy tube, and the holmium laser under a fibro-laryngoscope were applied for the patients with grade Ⅲ airway stenosis.Two hundred and sixteen patients were enrolled in this study. Forty-four patients had been found tracheal stenosis caused by granulomatous hyperplasia, accounting for 20.4% of all patients, including 12 cases of gradeⅠ, 18 cases of grade Ⅱ, and 14 cases of grade Ⅲ.Result:Thirty patients with grade Ⅰ and Ⅱ were replaced with adjustable flange tracheostomy cannula. Fourteen cases of grade Ⅲ airway stenosis were treated with Ho:YAG laser under a fibro laryngoscope. All cases were completed operation successfully. None of cases bleeding, perforated and asphyxia during operation. The clinical symptoms disappeared after operation, and endoscopy showed that airways of patients were smooth. No recurrence were found after operation.

Conclusion

Replacement of adjustable flange tracheostomy tube and Ho:YAG laser can safely and effectively treat airway obstruction caused by tracheal granulation tissue hyperplasia after tracheotomy.