Butnaru C S, Colreavy M P, Ayari S, Froehlich P
Otolaryngology Department, Edouard Herriot Universitary Hospital, Place d'Arsonval, 69437 Lyon Cedex 03, France.
Int J Pediatr Otorhinolaryngol. 2006 Jan;70(1):115-9. doi: 10.1016/j.ijporl.2005.05.028. Epub 2005 Sep 16.
To evaluate the evolution of indications for tracheostomy in children.
A retrospective review of 46 children undergoing tracheostomy between 1996 and 2001.
The indications for tracheostomy were classified in two groups:(1) prolonged ventilator dependence (57%), (2) upper airway obstructions (43%). The average age of the tracheostomy was 3 years and 8 months. This was higher in the first group (5.5 years). Decannulation was accomplished in 52%. The indications for tracheostomy were evaluated and were found to decrease in frequency for upper airway obstructions. An increasing indication was for chronic disorders requiring prolonged ventilator dependence. Complications occurred in 50% of children. Overall mortality was 13-2.7% directly related to the tracheostomy.
Evolving indication has been ventilator dependence. Upper airway obstruction as an indication has diminished in frequency, especially with the concomitant progress of endoscopic techniques.
评估儿童气管切开术适应证的演变情况。
对1996年至2001年间接受气管切开术的46例儿童进行回顾性研究。
气管切开术的适应证分为两组：（1）长期依赖呼吸机（57%），（2）上气道梗阻（43%）。气管切开术的平均年龄为3岁8个月。第一组（5.5岁）的年龄更高。52%的患儿实现了拔管。对气管切开术的适应证进行了评估，发现上气道梗阻的发生率有所下降。越来越多的适应证是需要长期依赖呼吸机的慢性疾病。50%的儿童出现了并发症。总体死亡率为13% - 2.7%，与气管切开术直接相关。
适应证的演变一直是依赖呼吸机。上气道梗阻作为一种适应证的发生率有所下降，尤其是随着内镜技术的同步发展。
