Department of Orthopedic Surgery, Weifang Traditional Chinese Medicine Hospital, Weifang, Shandong, China.
Department of Orthopedic Surgery, The 80th Army Hospital of PLA, Weifang, Shandong, China.
J Coll Physicians Surg Pak. 2020 Sep;30(9):956-960. doi: 10.29271/jcpsp.2020.09.956.
To evaluate the clinical efficacy and safety of early tracheotomy versus delayed tracheotomy for patients with cervical spinal cord injury.
A descriptive study.
Department of Orthopedic Surgery, The 80th Army Hospital of PLA, Weifang, Shandong, China, from January 2012 to June 2019.
Data of 45 patients with cervical spinal cord injury, who underwent tracheotomy and cervical spine internal fixation at the study place, were retrospectively analysed. Twenty-five patients underwent tracheotomy immediately after cervical spine internal fixation (early tracheotomy group) and 20 patients underwent tracheotomy 3-12 days after cervical spine internal fixation (delayed tracheotomy group). Clinical outcomes and tracheotomy complications were compared between the two groups.
Compared with the delayed tracheotomy, the early tracheotomy significantly reduced the total duration of mechanical ventilation (p <0.01), duration of mechanical ventilation after tracheotomy (p <0.05), duration of indwelling tracheal tube (p <0.05), and hospital stay (p <0.01). There were no significant differences in pneumonia, mortality, and complications related to tracheotomy between the groups. No incision infection for tracheotomy and cervical spine internal fixation were found in all patients.
Compared with delayed tracheotomy, early tracheotomy can significantly reduce the duration of mechanical ventilation, duration of indwelling tracheal tube, and hospital stay. Early tracheotomy did not increase the risk of infection of the cervical spine internal fixation. Therefore, early tracheotomy was beneficial and safe for patients. Key Words: Spinal cord injuries, Tracheotomy, Complications.
评估颈椎脊髓损伤患者早期气管切开与延迟气管切开的临床疗效和安全性。
描述性研究。
中国山东潍坊解放军第 80 军医院骨科，2012 年 1 月至 2019 年 6 月。
回顾性分析了在研究地点行气管切开和颈椎内固定的 45 例颈椎脊髓损伤患者的数据。25 例患者在颈椎内固定后立即行气管切开术（早期气管切开组），20 例患者在颈椎内固定后 3-12 天行气管切开术（延迟气管切开组）。比较两组患者的临床结局和气管切开并发症。
与延迟气管切开相比，早期气管切开显著缩短了机械通气总时间（p<0.01）、气管切开后机械通气时间（p<0.05）、气管内插管留置时间（p<0.05）和住院时间（p<0.01）。两组间肺炎、死亡率和与气管切开相关的并发症无显著差异。所有患者均未发现气管切开和颈椎内固定的切口感染。
与延迟气管切开相比，早期气管切开可显著缩短机械通气时间、气管内插管留置时间和住院时间。早期气管切开并未增加颈椎内固定感染的风险。因此，早期气管切开对患者有益且安全。关键词：脊髓损伤；气管切开术；并发症。
