Wetmore R F, Marsh R R, Thompson M E, Tom L W
Department of Pediatric Otolaryngology, The Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, 19104, USA.
Ann Otol Rhinol Laryngol. 1999 Jul;108(7 Pt 1):695-9. doi: 10.1177/000348949910800714.
In 1982, the experience with tracheostomy at The Children's Hospital of Philadelphia was reported for 1971 through 1980. We have now reviewed 450 cases for the period from 1981 through 1992, and compared the characteristics of these cases with those in the previous review. Long-term follow-up was available on 83% of cases, and the median follow-up was 2.96 years. Patients received a tracheostomy for airway obstruction (38%), chronic ventilation (53%), or multiple indications (9%). The mean duration of tracheotomy (adjusted for death and loss to follow-up) was 2.13 years. The tracheostomy-related mortality was 0.5%, and the nontracheostomy-related mortality was 22%. Nineteen percent of patients had complications in the first postoperative week, and 58% had 1 or more late complications. In comparison with the previous study from our institution, there was a great increase in long-term tracheostomy and a continuing trend away from tracheostomy for short-term airway management. Better monitoring and improvements in parental teaching may have contributed to a decrease in tracheostomy-related mortality.
1982年，有人报道了费城儿童医院1971年至1980年期间的气管造口术经验。我们现在回顾了1981年至1992年期间的450例病例，并将这些病例的特征与之前回顾中的病例进行了比较。83%的病例有长期随访，中位随访时间为2.96年。患者因气道阻塞（38%）、慢性通气（53%）或多种指征（9%）接受气管造口术。气管切开术的平均持续时间（根据死亡和失访情况调整）为2.13年。气管造口术相关死亡率为0.5%，非气管造口术相关死亡率为22%。19%的患者在术后第一周出现并发症，58%的患者有1种或更多晚期并发症。与我们机构之前的研究相比，长期气管造口术大幅增加，并且越来越倾向于不再将气管造口术用于短期气道管理。更好的监测和家长教育的改善可能有助于降低气管造口术相关死亡率。
