罕見的醫源性器管支氣管內異物：呼吸道交換導管

An Unusual Tracheobronchial Iatrogenic Foreign Body-Airway Exchange Catheter

處理呼吸道的異物對臨床醫師是一項挑戰。文獻報告少見醫源性異物在氣管支氣管內。臨床醫師經常使用呼吸道交換導管當作指引來為長期氣管插管的病人替換氣管內管，但是呼吸道交換導管的材貨可能老化造成斷裂。本文報導一罕見個案，更替氣管內管時呼吸道交換導管斷裂並掉落在氣管支氣管內，經胸腔內科支氣管鏡辛苦取出。我們建議臨床醫師在使用呼吸道交換導管來替換氣管內管之前及之後應檢查交換導管的長度及脆性，以避免醫源性的疏失。

Treating foreign bodies in the airway is a challenging clinical problem for clinicians. Reports on iatrogenic foreign bodies in the tracheobronchial tree (TBT) are rare. The physicians usually use an airway exchange catheter (AEC) as a guidewire to replace the endotracheal tube for prolonged intubated patients who refuse tracheostomies. However, the aging of the catheter material may make it fragile and vulnerable. Herein, we report a rare case of a broken guidewire, AEC, in the TBT after replacement of the endotracheal tube. We recommend the physicians perform a check-up for length and fragility of the AEC before and after endotracheal tube replacement. (J Med Health. 2016;5(1):111-129)