General Hospital of Korinthos, Corinth, Greece.
Eur Arch Otorhinolaryngol. 2011 Mar;268(3):323-30. doi: 10.1007/s00405-010-1398-5. Epub 2010 Oct 19.
The choice between surgical (ST) and percutaneous tracheostomy (PT) is not often based on evidence. The aim is to evaluate the quality of evidence in published articles comparing the two methods. A MEDLINE search was done. From 298 articles found, 37 fulfilled the inclusion criteria and 35 were further analyzed. No study was based on type I evidence, 13 (37%) represented type II, in 1 (3%) a clear-cut definition between type II or III was not possible and 21 (60%) represented type III or IV evidence. Taking into account the complication rate of the 13 type II evidence studies, 7 are in favor of PT and 3 in favor of ST. The majority of studies comparing PT with ST are of type III or IV level of evidence. Even if only type II studies are analyzed, outcomes are controversial. Any claims by clinicians in favor of a particular treatment are still debatable.
手术（ST）和经皮气管切开术（PT）之间的选择通常不是基于证据。目的是评估比较两种方法的已发表文章的证据质量。进行了 MEDLINE 搜索。从发现的 298 篇文章中，有 37 篇符合纳入标准，并进一步分析了 35 篇。没有一项研究基于 I 类证据，13 项（37%）为 II 类，1 项（3%）不可能明确界定为 II 类或 III 类，21 项（60%）为 III 类或 IV 类证据。考虑到 13 项 II 类证据研究的并发症发生率，7 项有利于 PT，3 项有利于 ST。比较 PT 与 ST 的大多数研究为 III 类或 IV 级证据。即使只分析 II 类研究，结果也是有争议的。临床医生支持特定治疗的任何主张仍然值得商榷。
