Lee Young Chan, Kim Tae Hyun, Lee Jung-woo, Oh In-Hwan, Eun Young Gyu
Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University.
Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University.
Respir Care. 2015 May;60(5):651-7. doi: 10.4187/respcare.03652. Epub 2015 Jan 27.
Although the benefits of early tracheostomy have been discussed in numerous studies, it is still unclear whether it is safe to perform early tracheostomy on unstable stroke patients. The purpose of this study is to assess the influences of the timing of tracheostomy on the incidence of complications following surgical tracheostomy in stroke patients.
We retrospectively performed chart reviews of 95 stroke subjects who underwent tracheostomy. In terms of timing, procedures performed within 7 d of intubation were categorized as early tracheostomy, and those performed after 7 d were categorized as standard tracheostomy. The incidence of complications following tracheostomy was compared between the two groups. The risk factors for complication were also investigated.
Among the 95 subjects, 59 (62.1%) received early tracheostomy and 36 (37.9%) received standard tracheostomy. The overall incidence of tracheostomy complications was 24.2%, and there was no significant difference in incidence between the two groups. A comparison of risk factors between the groups with and without complications revealed no significant differences in age, sex, body mass index, Glasgow coma scale score, stroke type, or history of underlying disease. However, activated partial thromboplastin time was significantly higher in the group with complication.
There was no significant difference in the incidence of complications in stroke subjects undergoing early versus standard tracheotomy.
尽管众多研究已探讨了早期气管切开术的益处,但对于不稳定的中风患者实施早期气管切开术是否安全仍不明确。本研究的目的是评估气管切开时机对中风患者手术气管切开术后并发症发生率的影响。
我们回顾性地查阅了95例行气管切开术的中风患者的病历。在时机方面,插管后7天内实施的手术归类为早期气管切开术,7天后实施的归类为标准气管切开术。比较两组气管切开术后并发症的发生率。同时也调查了并发症的危险因素。
95例患者中,59例(62.1%)接受了早期气管切开术,36例(37.9%)接受了标准气管切开术。气管切开术并发症的总体发生率为24.2%,两组发生率无显著差异。有并发症组与无并发症组之间的危险因素比较显示,年龄、性别、体重指数、格拉斯哥昏迷量表评分、中风类型或基础疾病史均无显著差异。然而,有并发症组的活化部分凝血活酶时间显著更高。
中风患者接受早期与标准气管切开术的并发症发生率无显著差异。