Coyle Margaret J, Tyrrell Robert, Godden Andrew, Hughes Ceri W, Perkins Charles, Thomas Steve, Godden Daryl
Department of Oral and Maxillofacial Surgery, Frenchay Hospital, North Bristol NHS Trust, Frenchay Park Road, Bristol BS16 1LE, UK.
Br J Oral Maxillofac Surg. 2013 Sep;51(6):493-6. doi: 10.1016/j.bjoms.2013.01.005. Epub 2013 Feb 8.
In maxillofacial head and neck oncology, tracheostomy is often used to secure the airway, but not without risk. This study compared the existing practice of two units: one where tracheostomy was routinely done with one where overnight intubation was used. From both units we retrospectively analysed 50 consecutive patients who had intraoral resection, neck dissection, and microvascular reconstruction for head and neck cancer. When compared with tracheostomy, overnight intubation resulted in a shorter mean stay in the intensive therapy unit (ITU) (1.4 compared with 3.7 days), a shorter overall hospital stay (12.9 compared with 18.0 days), less time to first oral intake (8.9 compared with 12.8 days), and a lower rate of lower respiratory tract infection (LRTI) (10% compared with 38%). This study supports the discontinuation of routine tracheostomy and the adoption of a more selective practice to improve recovery.
在颌面头颈肿瘤学中，气管切开术常用于确保气道通畅，但并非没有风险。本研究比较了两个科室的现有做法：一个科室常规进行气管切开术，另一个科室采用过夜插管。我们对两个科室连续50例因头颈癌接受口腔内切除、颈部清扫和微血管重建的患者进行了回顾性分析。与气管切开术相比，过夜插管导致重症监护病房（ITU）的平均住院时间更短（分别为1.4天和3.7天），总体住院时间更短（分别为12.9天和18.0天），首次经口进食时间更短（分别为8.9天和12.8天），下呼吸道感染（LRTI）发生率更低（分别为10%和38%）。本研究支持停止常规气管切开术，并采用更具选择性的做法以改善恢复情况。
