Kaneda T, Saga T, Kitayama H, Nakamoto S, Kawasaki H, Takaba K, Imura M, Fujii K, Nishino T, Yukami S
Department of Cardiovascular Surgery, Kinki University, Osakasayama, Japan.
Kyobu Geka. 2011 May;64(5):387-9.
Recent good results of cardiovascular surgery have led to expansion of its indication to elderly patients and patients with serious complications. Such patients may have serious respiratory complications after cardiac surgery and need to undergo tracheostomy relatively early in the postoperative period. Although the full sternotomy approach is the standard in almost all cardiac surgeries, superficial and deep sternal infections are rather common after early tracheostomy in full sternotomy patients. The lower partial sternotomy approach is a safer and more useful procedure in patients who will need tracheostomy in the early period after cardiac surgery. We report on 2 patients who were successfully tracheostomized within a week after cardiac surgery, with a review of the literature.
近期心血管外科手术取得的良好成果已促使其适应证扩大至老年患者及伴有严重并发症的患者。这类患者在心脏手术后可能会出现严重的呼吸并发症,并且需要在术后相对早期接受气管切开术。尽管全胸骨切开术是几乎所有心脏手术的标准术式,但在接受全胸骨切开术的患者中,早期气管切开术后表浅和深部胸骨感染相当常见。对于心脏手术后早期需要气管切开术的患者,下部分胸骨切开术是一种更安全且更有用的术式。我们报告了2例在心脏手术后一周内成功实施气管切开术的患者,并对相关文献进行了综述。