Peris A, Linden M, Pellegrini G, Anichini V, Di Filippo A
Unit of Anesthesia and Intensive Care, Department of Emergency, Careggi Teaching Hospital, Florence, Italy.
Minerva Anestesiol. 2009 Jan-Feb;75(1-2):21-5. Epub 2008 Nov 6.
The aim of this study was to demonstrate that performance of percutaneous dilatational tracheostomy (PDT) associated with a self-drive control technique lowers the incidence of complications.
A case-control, before-and-after, retrospective study. Place of study: A major teaching hospital in the Department of Emergency, Intensive Care Unit.
we studied 128 patients who underwent fiberoptic-guided PDT over an 18 month period of time. Thirty-nine patients were assisted by conventional fiberoptic bronchoscopy, while 89 video-assisted fiberoptic procedures were performed in which the operator controlled his own actions on a screen. We defined perioperative complications as accidental extubation, perioperative hemorrhage, tracheal ring rupture, lesions of the tracheal wall, and abnormal insertion of the cannula. A Chi-square test, Student's t-test and U Mann Whitney test were used to compare the incidence of complications and the duration of procedure in the traditional fiberoptic PDT group and in the video-guided group.
Procedure time was significantly shorter in the group with the self-drive control technique. There was also a reduction of the number of perioperative complications.
Fiberoptic bronchoscopy associated with a video system seems effective in reducing the risk of perioperative complications.
本研究的目的是证明采用自控技术的经皮扩张气管切开术（PDT）可降低并发症的发生率。
一项病例对照、前后对比的回顾性研究。研究地点：某大型教学医院急诊科重症监护病房。
我们研究了128例在18个月期间接受纤维支气管镜引导下PDT的患者。39例患者由传统纤维支气管镜辅助，而89例采用视频辅助纤维支气管镜操作，操作者在屏幕上控制自己的操作。我们将围手术期并发症定义为意外拔管、围手术期出血、气管环破裂、气管壁损伤和套管异常插入。采用卡方检验、学生t检验和曼-惠特尼U检验比较传统纤维支气管镜引导下PDT组和视频引导组的并发症发生率及手术时间。
自控技术组的手术时间明显更短。围手术期并发症的数量也有所减少。
与视频系统相结合的纤维支气管镜检查似乎能有效降低围手术期并发症的风险。
