Randell T, Kalli I, Lindgren L
Department of Anaesthesia, Helsinki University Central Hospital, Finland.
Anaesthesia. 1990 Oct;45(10):875-9. doi: 10.1111/j.1365-2044.1990.tb14577.x.
Complications and changes in tracheal mucosa after minitracheotomy were evaluated in 28 patients. Tracheal mucosa was inspected fibreoptically after the insertion of a minitracheotomy cannula, and then at 3-day intervals until the cannula was removed. Thereafter, assessments were made every third day until the mucosa was considered normal. Three significant complications occurred: mediastinal puncture, paratracheal entrance of the cannula and subcutaneous emphysema. Difficulties at insertion of the minitracheotomy cannula were encountered in 15 of 28 patients (54%). Air flow detected through the cannula in one patient, and lack of air flow in another patient, were misleading signs of the position of the cannula. Passing a suction catheter in three patients and a normal end-tidal carbon dioxide tracing in one patient, were also found to be misleading. The correct position and possible complications could be verified only by fibreoptic tracheoscopy. Changes in the tracheal mucosa were independent of the duration of minitracheotomy therapy.
对28例患者在实施微创气管切开术后的气管黏膜并发症及变化进行了评估。在插入微创气管切开套管后，通过纤维支气管镜检查气管黏膜，然后每隔3天检查一次，直至套管拔除。此后，每三天进行一次评估，直至黏膜被认为恢复正常。发生了3例严重并发症：纵隔穿刺、套管旁气管进入和皮下气肿。28例患者中有15例（54%）在插入微创气管切开套管时遇到困难。一名患者通过套管检测到气流，另一名患者未检测到气流，这些都是套管位置的误导性迹象。在三名患者中插入吸引导管以及在一名患者中出现正常的呼气末二氧化碳曲线，也被发现具有误导性。只有通过纤维支气管镜检查才能确定正确位置和可能的并发症。气管黏膜的变化与微创气管切开术治疗的持续时间无关。
