Petros S
Universität Leipzig, Medizinische Klinik und Poliklinik I, Abteilung für Intensivmedizin, Leipzig, Germany.
Crit Care. 1999;3(2):R5-R10. doi: 10.1186/cc340.
Percutaneous tracheostomy (PT) has gained an increasing acceptance as an alternative to the conventional surgical tracheostomy (ST). In experienced hands, and with proper patient selection, it is safe, easy and quick. COMPLICATIONS: Perioperative complications are comparable with those of ST and these are mostly minor. An important advantage of PT over ST is that there is no need to move a critically ill patient to the operating room and the rate of stomal infection is very low. Although data on late complications of PT are not yet sufficient, available reports show a favourable result. TECHNIQUES: Ciaglia's method is the most commonly applied, but no study has shown superiority of any of the percutaneous techniques described. The decision on which method to use should solely be made depending on the clinical situation and the experience of the operator. The learning curve demands caution, attention to detail and adequate experience on the part of the intensive care physician. Although PT is unfortunately declared 'easy', it must be left in the hands of experienced physicians to avoid unnecessary complications, and the risk of overimplementation should be kept in mind.
经皮气管切开术（PT）作为传统外科气管切开术（ST）的替代方法，越来越被人们所接受。在经验丰富的医生手中，并且选择合适的患者，该手术安全、简便且快捷。
围手术期并发症与ST相当，且大多为轻微并发症。PT相对于ST的一个重要优势在于无需将重症患者转移至手术室，且造口感染率非常低。尽管关于PT晚期并发症的数据尚不充分，但现有报告显示结果良好。
Ciaglia法是最常用的方法，但尚无研究表明所描述的任何一种经皮技术具有优越性。使用哪种方法的决定应仅根据临床情况和操作者的经验来做出。学习曲线要求重症监护医生谨慎、注重细节并具备足够的经验。尽管遗憾的是PT被宣称“简单”，但必须由经验丰富的医生操作以避免不必要的并发症，同时应牢记过度实施的风险。
