Mieth M, Schellhaaß A, Hüttner F J, Larmann J, Weigand M A, Büchler M W
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
Klinik für Anästhesie, Intensiv- und Notfallmedizin, Rotes Kreuz Krankenhaus Kassel, Kassel, Deutschland.
Chirurg. 2016 Jan;87(1):73-83; quiz 84-5. doi: 10.1007/s00104-015-0116-7.
Due to the comprehensive establishment of modern techniques, tracheostomy has become a routine procedure in intensive care units (ICU). The negative effects of prolonged translaryngeal intubation on the laryngeal and tracheal mucosa up to tracheal stenosis can be reduced by tracheostomy. Furthermore, long-term ventilation is facilitated; however, there is no clear evidence on the optimal timing of tracheostomy in critically ill patients. The specific indications and contraindications of surgical as well as percutaneous tracheostomy must be strictly observed for a safe and successful intervention. Exchanging the tracheostomy tube may lead to potentially dangerous situations especially after percutaneous tracheostomy. A standardized and structured approach is therefore recommended.
由于现代技术的全面发展，气管切开术已成为重症监护病房（ICU）的常规操作。气管切开术可减少经喉长期插管对喉和气管黏膜直至气管狭窄的负面影响。此外，便于长期通气；然而，对于危重症患者气管切开术的最佳时机尚无明确证据。为了安全、成功地进行干预，必须严格遵守手术及经皮气管切开术的具体适应证和禁忌证。更换气管切开套管可能会导致潜在的危险情况，尤其是在经皮气管切开术后。因此，建议采用标准化和结构化的方法。
