Alladi A, Rao S, Das K, Charles A R, D'Cruz A J
Department of Pediatric Surgery, St. John's Medical College Hospital, 560034 Bangalore, India.
Pediatr Surg Int. 2004 Sep;20(9):695-8. doi: 10.1007/s00383-004-1277-5. Epub 2004 Sep 21.
Pediatric tracheostomy has been reported to be a surgical procedure with significant morbidity and mortality. The use of tracheostomy in airway management has changed over time as regards indication and outcome. A review of the last 13 years' experience in our institution was carried out to focus on this group of patients and the recent trends in airway management. A retrospective analysis of hospital records was done and information collected with respect to age, gender, indication for tracheostomy, duration, complications, and follow-up. Thirty-nine tracheotomies were done in 36 patients, of whom males outnumbered females 2:1. The mean patient age was 41.6 months while nearly a third were newborns. The indications were congenital and acquired obstructive lesions. Apart from nine cases, all have been treated and decannulated. Follow-up ranged from 1 month to 8 years, and decannulation time from 48 h to 45 months. Home tracheostomy care was very well managed by the parents. One tracheostomy-related death was encountered. Complications were minor and transient and occurred post-decannulation in our series, in contrast to the major complications, both acute and chronic, reported in the literature. More neonates and infants are undergoing tracheostomy and surviving. Pediatric tracheostomy is a safe procedure with home care by parents feasible.
据报道，小儿气管切开术是一种具有较高发病率和死亡率的外科手术。随着时间的推移，气管切开术在气道管理中的应用在适应证和结果方面发生了变化。我们回顾了本机构过去13年的经验，以关注这组患者以及气道管理的最新趋势。对医院记录进行了回顾性分析，并收集了有关年龄、性别、气管切开术适应证、持续时间、并发症和随访情况的信息。36例患者共进行了39次气管切开术，其中男性与女性的比例为2:1。患者的平均年龄为41.6个月，近三分之一为新生儿。适应证为先天性和后天性阻塞性病变。除9例患者外，其他患者均已接受治疗并拔管。随访时间从1个月到8年不等，拔管时间从48小时到45个月不等。家长对家庭气管切开术护理管理得很好。发生了1例与气管切开术相关的死亡。与文献报道的急性和慢性严重并发症不同，我们系列中的并发症轻微且短暂，发生在拔管后。越来越多的新生儿和婴儿正在接受气管切开术并存活下来。小儿气管切开术是一种安全的手术，家长进行家庭护理是可行的。
