Ruggiero Francis P, Carr Michele M
Division of Otolaryngology, Department of Surgery, Penn State/Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.
Arch Otolaryngol Head Neck Surg. 2008 Mar;134(3):263-7. doi: 10.1001/archoto.2007.24.
To identify practice patterns regarding tracheotomy technique among pediatric otolaryngologists.
Survey of physicians.
Academic medical center.
Members of the American Society of Pediatric Otolaryngology (ASPO) residing in the United States.
Physician responses to survey questions, including both multiple choice and free-text responses. We used chi(2) tests to determine if demographic factors (pediatric otolaryngology fellowship training, the number of tracheotomies performed yearly) correlated with differences in the technique used to perform infant tracheotomies.
A total of 168 of 225 surveys mailed to ASPO members (75%) were completed and returned. Most respondents (87%) report that they make a simple vertical incision in the trachea. An even greater number (94%) use stay sutures routinely. On other technical points, such as management of the thyroid gland, the subcutaneous fat, and the method of securing the tracheostomy tube, there was much greater variability: 22% of respondents reported having had a serious tracheotomy-related complication in the immediate postoperative period, and 58% of these physicians changed their technique as a result. In several areas, chi(2) analysis revealed statistically significant differences in technique that were dependent on both fellowship training and the number of tracheotomies performed (P < or = .05).
Among ASPO members practicing in the United States, there is near-unanimity on certain technical points, with considerable divergence on others. A substantial percentage of our colleagues have experienced a tracheotomy-related complication in the early postoperative period. In many cases, these incidents led to changes in surgical technique.
确定儿科耳鼻喉科医生在气管切开术技术方面的实践模式。
医生调查。
学术医疗中心。
居住在美国的美国儿科耳鼻喉科学会（ASPO）成员。
医生对调查问卷问题的回答，包括多项选择题和自由文本回答。我们使用卡方检验来确定人口统计学因素（儿科耳鼻喉科进修培训、每年进行的气管切开术数量）是否与婴儿气管切开术所用技术的差异相关。
邮寄给ASPO成员的225份调查问卷中，共有168份（75%）完成并返回。大多数受访者（87%）报告称他们在气管上做一个简单的垂直切口。使用牵引缝线的人数更多（94%）。在其他技术要点上，如甲状腺、皮下脂肪的处理以及气管造口管的固定方法，差异更大：22%的受访者报告在术后即刻发生过严重的气管切开术相关并发症，其中58%的医生因此改变了他们的技术。在几个领域，卡方分析显示技术上存在统计学显著差异，这取决于进修培训和气管切开术的执行数量（P≤0.05）。
在美国执业的ASPO成员中，在某些技术要点上几乎达成一致，但在其他方面存在很大差异。相当比例的同事在术后早期经历过气管切开术相关并发症。在许多情况下，这些事件导致了手术技术的改变。
