[经皮扩张气管切开术后常规胸部X线检查的作用。一项前瞻性随机研究]
[The role of routine chest radiography after percutaneous dilatational tracheostomy. A prospective randomized study].
作者信息
Weidhase L, Mende L, de Fallois J, Petros S
机构信息
Interdisziplinäre Internistische Intensivmedizin, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.
出版信息
Med Klin Intensivmed Notfmed. 2013 Oct;108(7):584-7. doi: 10.1007/s00063-013-0269-4. Epub 2013 Jul 13.
BACKGROUND
Routine chest radiography (X-ray) after percutaneous dilatational tracheostomy has been considered standard procedure in the past. However, recent observations show this to be unnecessary and cost ineffective. Prospective randomised trials have been lacking.
PATIENT AND METHODS
Critically ill patients admitted to an ICU with an indication for a percutaneous tracheostomy were consecutively randomized into group 1 (routine postprocedural chest X-ray) and group 2 (chest X-ray only when considered clinically indicated). Tracheostomy was performed under bronchoscopic guidance.
RESULTS
A total of 100 patients (50 per group) were included. Three major complications were observed in group 1 and one presumed complication in group 2. There were 11 minor complications in group 1 and 16 in group 2. Routine chest X-ray in group 1 did not reveal any abnormality related to the tracheostomy. A control chest X-ray was considered necessary in only one patient in group 2, but with no pathological change observed.
CONCLUSION
Routine chest radiography after a percutaneous dilatational tracheostomy conducted under fibre optic bronchoscopic guidance is probably not useful.
背景
过去，经皮扩张气管切开术后进行常规胸部X线检查被视为标准程序。然而，最近的观察表明这并无必要且成本效益不高。此前缺乏前瞻性随机试验。
患者与方法
因需进行经皮气管切开术而入住重症监护病房（ICU）的重症患者被连续随机分为两组，第1组（术后常规进行胸部X线检查）和第2组（仅在临床认为有必要时进行胸部X线检查）。气管切开术在支气管镜引导下进行。
结果
共纳入100例患者（每组50例）。第1组观察到3例主要并发症，第2组观察到1例疑似并发症。第1组有11例轻微并发症，第2组有16例。第1组的常规胸部X线检查未发现与气管切开术相关的任何异常。第2组仅1例患者被认为有必要进行对照胸部X线检查，但未观察到病理变化。
结论
在纤维支气管镜引导下进行经皮扩张气管切开术后常规进行胸部X线检查可能并无用处。
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