Parrilla Claudio, Scarano Emanuele, Guidi Maria Lavinia, Galli Jacopo, Paludetti Gaetano
Institute of Otolaryngology, Sacro Cuore Catholic University, Rome, Italy.
Int J Pediatr Otorhinolaryngol. 2007 Oct;71(10):1563-7. doi: 10.1016/j.ijporl.2007.06.009. Epub 2007 Jul 12.
In the 1970s, the most common indication for tracheostomy in children was acute inflammatory airway obstruction. Modern neonatal intensive care units have turned long-term intubation into an alternative to tracheostomy. Long-term intubation itself has become the most important indication for tracheostomy combined with subglottic stenosis.
Retrospective analysis in a tertiary referral center. A total of 38 patients who underwent tracheostomy for respiratory failure and upper airway obstruction from 1 November 1998 to 30 November 2004.
Total complication rate was 42.1%. In children under 1 year of age the complication rate was 47.4%, in children over 1 year the complication rate was 26.3%. Decannulation was attempted in 12 patients with a cannulation time of 22 months.
Long-term intubation and its sequelae have now become one of the most important indication for tracheostomy. The change of indication has also entailed a decrease of the average age of children who require tracheostomy. A longer period before decannulation and a lower average age have changed the complication rate of tracheostomy in paediatric patients.
在20世纪70年代，儿童气管切开术最常见的指征是急性炎性气道梗阻。现代新生儿重症监护病房已将长期插管作为气管切开术的一种替代方法。长期插管本身已成为气管切开术合并声门下狭窄的最重要指征。
在一家三级转诊中心进行回顾性分析。对1998年11月1日至2004年11月30日期间因呼吸衰竭和上气道梗阻接受气管切开术的38例患者进行分析。
总并发症发生率为42.1%。1岁以下儿童的并发症发生率为47.4%，1岁以上儿童的并发症发生率为26.3%。对12例插管时间为22个月的患者尝试进行拔管。
长期插管及其后遗症现已成为气管切开术最重要的指征之一。指征的变化也导致了需要气管切开术的儿童平均年龄的降低。拔管前较长的时间和较低的平均年龄改变了儿科患者气管切开术的并发症发生率。
