Mastboom W J, Wobbes T, van den Dries A, Goris R J
Department of General Surgery, University Hospital, Nijmegen, The Netherlands.
Surg Gynecol Obstet. 1991 Sep;173(3):187-92.
Bronchial suction by means of a minitracheostomy is a new method for treatment of sputum retention and related pulmonary diseases. Through a small coniotomy, a specially designed cannula is inserted into the trachea, allowing frequent bronchial suction. The effectiveness of this method was prospectively analyzed in 74 consecutive patients and the results were compared with those reported in the literature. The operative procedure for insertion of the Minitracheotomy cannula caused nonlethal bleeding in three patients who were receiving anticoagulant medications. Thirty-eight of 43 patients treated on the intensive care ward were detubated and dismissed at an earlier stage than usual because of a minitracheostomy. The method failed in two comatose patients and in one patient with a laryngeal tumor. The method was effective in 18 patients who had serious pulmonary disease postoperatively. Thirteen patients at high risk for pulmonary infections, in whom the cannula had been prophylactically applied after extensive operations, did not have postoperative pulmonary complications. Over-all, the median period for bronchial suction was 4.0 days; decannulation followed on average 4.7 days later. No complications were caused by the presence of the cannula and the device was well tolerated by the patients.
通过微型气管切开术进行支气管吸引是一种治疗痰液潴留及相关肺部疾病的新方法。通过一个小的环甲膜切开术，将一个特殊设计的套管插入气管，从而能够频繁进行支气管吸引。对74例连续患者前瞻性分析了该方法的有效性，并将结果与文献报道进行了比较。插入微型气管切开术套管的手术操作在3例正在接受抗凝药物治疗的患者中导致了非致命性出血。重症监护病房接受治疗的43例患者中有38例因微型气管切开术而比平常更早拔除气管插管并出院。该方法在2例昏迷患者和1例喉肿瘤患者中失败。该方法对18例术后患有严重肺部疾病的患者有效。13例肺部感染高危患者在进行广泛手术后预防性应用了套管，未发生术后肺部并发症。总体而言，支气管吸引的中位时间为4. 0天；平均4. 7天后拔管。套管的存在未引起并发症，患者对该装置耐受性良好。
