小儿气管切开术：273例手术技术与早期及晚期并发症的比较
Pediatric Tracheotomy: Comparison of surgical technique with early and late complications in 273 cases.
作者信息
Gumussoy Murat
机构信息
Murat Gumussoy, M.D. Assistant Professor, Otorhinolaryngologist, Department of Otolaryngology Head and Neck Surgery, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey.
出版信息
Pak J Med Sci. 2019 Jan-Feb;35(1):247-251. doi: 10.12669/pjms.35.1.132.
OBJECTIVES
This study was aimed to compare the early and late complications of tracheotomy in pediatric patient, with respect to surgical techniques.
METHODS
The relationship between demographic characteristics, surgical techniques obtained from the files of the children and complications developing after surgery were compared retrospectively.
RESULTS
One hundred fifty two out of 273 developed complications after tracheotomy. Among these, 75 were early complications and 77 were late complications. Results obtained concerning early complications showed a significant difference between Skin incision and Bleeding and Accidental decannulation; Tracheal incision and Subcutaneous emphysema; surgical time and accidental decannulation and tube/ventilation problem; Surgeon's skill level and bleeding. As regards late complications there was a significant difference between Intubation Time and Stomal-tracheal granulation; Tracheal incision and Stomal infection; Surgeon's skill level and Stomal-tracheal granulation.
CONCLUSIONS
In pediatric tracheotomy the preferred skin incision and tracheal incision, surgeon's experience, tracheotomoy time and intubation time are important as regards development of early or late complications.
目的
本研究旨在比较小儿患者气管切开术在手术技术方面的早期和晚期并发症。
方法
回顾性比较从儿童病历中获取的人口统计学特征、手术技术与术后发生的并发症之间的关系。
结果
273例患者中有152例在气管切开术后出现并发症。其中，75例为早期并发症，77例为晚期并发症。关于早期并发症的结果显示，皮肤切口与出血及意外脱管之间；气管切口与皮下气肿之间；手术时间与意外脱管及导管/通气问题之间；外科医生的技术水平与出血之间存在显著差异。至于晚期并发症，插管时间与造口气管肉芽组织之间；气管切口与造口感染之间；外科医生的技术水平与造口气管肉芽组织之间存在显著差异。
结论
在小儿气管切开术中，首选的皮肤切口和气管切口、外科医生的经验、气管切开时间和插管时间对于早期或晚期并发症的发生很重要。
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