Friedman Y, Franklin C
Cook County Hospital, Chicago.
J Crit Illn. 1993 Feb;8(2):289-97.
Percutaneous tracheostomy is the procedure of choice for most patients who require prolonged use of an artificial airway; it can be performed rapidly at the bedside and is associated with fewer complications than is the standard procedure. The serial dilational technique involves the insertion of prelubricated dilators that gradually enlarge the diameter of a tract made by a guidewire and guiding catheter, facilitating placement of a standard double-cannula tracheostomy tube. The most dangerous complication, paratracheal insertion, occurs only rarely. The small skin incision and resulting tight fit of the tracheostomy tube in the stoma help prevent bleeding and infection.
经皮气管切开术是大多数需要长期使用人工气道的患者的首选手术；它可以在床边迅速进行，并且与标准手术相比并发症更少。连续扩张技术包括插入预先润滑的扩张器，这些扩张器逐渐扩大由导丝和引导导管形成的通道直径，便于放置标准的双套管气管切开术导管。最危险的并发症——气管旁插入，仅偶尔发生。气管切开术导管在造口处的小皮肤切口和由此产生的紧密贴合有助于防止出血和感染。
