Department of Surgery, Boston University School of Medicine, c/o Lana Ketlere, 88 East Newton Street, C515, Boston, MA 02118, USA.
World J Surg. 2012 Feb;36(2):266-9. doi: 10.1007/s00268-011-1380-4.
Chest radiography is routinely used post-tracheostomy to evaluate for complications. Often, the chest X-ray findings do not change clinical management. The present study was conducted to evaluate the utility of post-tracheostomy X-rays.
This retrospective review of 255 patients was performed at a single-center, university, level I trauma center. All patients underwent tracheostomy and were evaluated for postprocedure complications.
Of the 255 patients, 95.7% had no change in postprocedure chest X-ray findings. New significant chest X-ray findings were found in 4.3% of patients, including subcutaneous emphysema, pneumothorax, and new significant consolidation. Only three of these patients required change in clinical management, and all changes were based on clinical presentation alone.
Routine chest X-ray following tracheostomy fails to provide additional information beyond clinical examination. Therefore radiographic examination should be performed only after technically difficult procedures or if the patient experiences clinical deterioration. Significant cost savings and minimization of radiation exposure can be achieved when chest radiography after tracheostomy is performed exclusively for clinical indications.
气管切开术后常进行胸部 X 线检查以评估并发症。通常情况下，X 线检查结果不会改变临床治疗方案。本研究旨在评估气管切开术后 X 线检查的作用。
这是在一家单中心、大学附属、一级创伤中心进行的回顾性研究，共纳入 255 例患者。所有患者均接受了气管切开术，并对术后并发症进行了评估。
在 255 例患者中，95.7%的患者术后胸部 X 线检查结果无变化。4.3%的患者出现新的显著 X 线表现，包括皮下气肿、气胸和新的显著实变。仅 3 例患者需要改变临床治疗方案，所有改变均仅基于临床表现。
气管切开术后常规行胸部 X 线检查并不能提供临床检查以外的额外信息。因此，仅在技术难度较大的操作后或患者出现临床恶化时，才应进行放射影像学检查。仅在有临床指征时行气管切开术后 X 线检查，可显著节省费用并减少辐射暴露。
