Rao A S, Mansor L, Inbasegaran K
Department of Anaesthesia and Intensive Care, Kuala Lumpur Hospital, 50586, Kuala Lumpur.
Med J Malaysia. 2003 Jun;58(2):213-7.
During a 6-month period from October 2000 to March 2001, we analysed the indications, methods, waiting period and complications following a tracheostomy at the General Intensive Care Unit (GIGU) of Hospital Kuala Lumpur. There were 49 tracheostomies performed during this period. Thirty of them were performed in the GICU using the percutaneous dilatational method while 19 were performed electively in the Operating Theatre (OT) by the ear, nose and throat (ENT) surgeons. The main indications for a tracheostomy were prolonged mechanical ventilation and airway protection for patients with a poor Glasgow Coma Scale. The average waiting time for a tracheostomy after a decision was made to perform one was 1.34 +/- 0.72 days for a percutaneous tracheostomy and 3.72 +/- 2.52 days for a surgical tracheostomy. This difference was statistically significant (p < 0.001). There was excessive bleeding in 3 patients in the percutaneous tracheostomy group and 1 patient in the surgical tracheostomy group. Percutaneous tracheostomy is now the main method of tracheostomy at the GICU in Hospital Kuala Lumpur. Haemorrhage is the most significant complication of this procedure. However the overall complication rate is comparable with that of a surgical tracheostomy.
在2000年10月至2001年3月的6个月期间，我们分析了吉隆坡医院综合重症监护病房（GIGU）气管切开术的适应症、方法、等待时间和并发症。在此期间共进行了49例气管切开术。其中30例在GICU采用经皮扩张法进行，19例由耳鼻喉（ENT）外科医生在手术室（OT）择期进行。气管切开术的主要适应症是机械通气时间延长以及格拉斯哥昏迷评分低的患者的气道保护。决定进行气管切开术后，经皮气管切开术的平均等待时间为1.34±0.72天，外科气管切开术为3.72±2.52天。这种差异具有统计学意义（p<0.001）。经皮气管切开术组有3例患者出现大出血，外科气管切开术组有1例。经皮气管切开术目前是吉隆坡医院GICU气管切开术的主要方法。出血是该手术最严重的并发症。然而，总体并发症发生率与外科气管切开术相当。
