Rao B K, Pande R, Sharma S C, Ray S, Lakshmi B, Singh V K, Gupta R K, Suri S
Department of Anaesthesiology and Critical Care Medicine, Sir Gangaram Hospital, New Delhi, India.
Ann Card Anaesth. 2003 Jan;6(1):19-26.
The purpose of this review is to discuss the various techniques of percutaneous tracheostomy and to assess their safety and efficacy profile, indications and contraindications, early and late complications. Literature was reviewed from Medline and MD Consult databases. Early techniques by Sheldon, toye and Schachner have been abandoned due to their high complication rates. Percutaneous dilational tracheostomy using the Ciaglia kit (Wiliam Cook Europe Bjaeverskov) and a Griggs kit (Portex PDT kit, POrtex, Hythe, Kent, UK) has been used most often. Griggs guide Wire Dilator Forceps kit (SIMS, Portex, Hythe, Kent, UK) is the next most common in use but its long-term studies are few. Fantoni (TLT set, Mallinckrodt Medical) and PercuTwist device (Riisch, Kernen, Germany) are two new techniques currently under study. Percutaneous dilational tracheostomy and conventional surgical tracheostomy are still competing methods to provide an airway for intensive care patient requiring assisted ventilation. Review of literature shows that percutaneous tracheostomy is safe, cost-effective and compares favourably with the open surgical tracheostomy. Many intensive care units now use the percutaneous tracheostomy as a procedure of choice. Percutaneous tracheostomy has a learning curve and requires appropriate case selection and meticulous attention to the technique by all those who want to use this method.
本综述的目的是讨论经皮气管切开术的各种技术，并评估其安全性和有效性、适应证和禁忌证以及早期和晚期并发症。我们检索了Medline和MD Consult数据库中的文献。Sheldon、Toye和Schachner提出的早期技术因并发症发生率高而被摒弃。使用Ciaglia套件（威廉库克欧洲公司，比耶沃斯科夫）和Griggs套件（Portex PDT套件，Portex公司，英国肯特郡海斯）进行的经皮扩张气管切开术应用最为广泛。Griggs导丝扩张钳套件（SIMS公司，Portex公司，英国肯特郡海斯）是其次常用的套件，但关于它的长期研究较少。Fantoni（TLT套件，马林克罗特医疗公司）和PercuTwist装置（德国克嫩的Riisch公司）是目前正在研究的两种新技术。经皮扩张气管切开术和传统外科气管切开术仍是为需要辅助通气的重症监护患者建立气道的相互竞争的方法。文献综述表明，经皮气管切开术是安全的、具有成本效益的，与开放性外科气管切开术相比具有优势。现在许多重症监护病房将经皮气管切开术作为首选方法。经皮气管切开术有一个学习曲线，所有想要使用这种方法的人都需要进行适当的病例选择并严格注意技术操作。
