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不使用纤维支气管镜进行经皮扩张气管切开术。

Performing Percutaneous Dilational Tracheostomy without using Fiberoptic Bronchoscope.

作者信息

Yaghoubi Siamak, Massoudi Nilofar, Fathi Mohammad, Nooraei Navid, Khezri Marzieh Beygom, Abdollahi Sareh

机构信息

Department of Anaesthesiology, Qazvin University of Medical Sciences, Qazvin, Iran.

Clinical Research and Development Unit at Shahid Modarres Hospital, Department of Anaesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Tanaffos. 2020 Jan;19(1):60-65.

PMID:33101433
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7569499/
Abstract

BACKGROUND

Percutaneous tracheostomy is an elective method that is increasingly being taken up in the intensive care unit alongside the patient's bed. In many centers, bronchoscopy is used, but the necessity of using bronchoscopy in percutaneous tracheostomy has not yet been determined. Discontinuing use of bronchoscopy can potentially reduce the cost and increase the efficiency of percutaneous tracheostomy. Therefore, in this study, we performed a percutaneous dilatational tracheostomy without using fiberoptic bronchoscopy.

MATERIALS AND METHODS

This study was performed as a descriptive epidemiological survey among 70 patients in Shahid Rajaei Hospital of Qazvin in 2015 and 2016. The results were assessed in the patients.

RESULTS

In this study, pneumothorax, trauma, major and minor bleeding, cuff leak and change to surgical procedures as well as accidental extubation were not seen. However, subcutaneous emphysema, mal-position and hypoxia each were seen in one patient (1.4%).

CONCLUSION

Totally the results demonstrated that percutaneous dilatation tracheostomy without fiberoptic bronchoscopic guidance is useful and safe.

摘要

背景

经皮气管切开术是一种择期手术方法,越来越多地在重症监护病房患者床边开展。在许多中心,会使用支气管镜,但经皮气管切开术中使用支气管镜的必要性尚未确定。停止使用支气管镜可能会降低经皮气管切开术的成本并提高其效率。因此,在本研究中,我们进行了不使用纤维支气管镜的经皮扩张气管切开术。

材料与方法

本研究于2015年和2016年在加兹温的沙希德拉贾伊医院对70例患者进行了描述性流行病学调查。对患者的结果进行了评估。

结果

在本研究中,未观察到气胸、创伤、大出血和小出血、袖带漏气、改为外科手术以及意外拔管等情况。然而,皮下气肿、位置不当和低氧血症各有1例患者出现(1.4%)。

结论

总体结果表明,无纤维支气管镜引导的经皮扩张气管切开术是有用且安全的。

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本文引用的文献

1
Use of Bronchoscopy in Percutaneous Dilational Tracheostomy.支气管镜在经皮扩张气管切开术中的应用。
JAMA Otolaryngol Head Neck Surg. 2016 Feb;142(2):143-9. doi: 10.1001/jamaoto.2015.3123.
2
The role of fiberoptic bronchoscopy monitoring during percutaneous dilatational tracheostomy and its routine use into tracheotomy practice.纤维支气管镜监测在经皮扩张气管切开术中的作用及其在气管切开实践中的常规应用。
J Pak Med Assoc. 2016 Jan;66(1):83-9.
3
A Prospective Randomized Study Comparing Mini-surgical Percutaneous Dilatational Tracheostomy With Surgical and Classical Percutaneous Tracheostomy: A New Method Beyond Contraindications.一项比较微创经皮扩张气管切开术与外科手术及传统经皮气管切开术的前瞻性随机研究:一种突破禁忌证的新方法。
Medicine (Baltimore). 2015 Nov;94(47):e2015. doi: 10.1097/MD.0000000000002015.
4
Griggs percutaneous tracheostomy without bronchoscopic guidance is a safe method: A case series of 300 patients in a tertiary care Intensive Care Unit.三级护理重症监护病房300例患者的病例系列研究:无支气管镜引导下的 Griggs经皮气管切开术是一种安全的方法
Indian J Crit Care Med. 2014 Dec;18(12):778-82. doi: 10.4103/0972-5229.146303.
5
Tracheostomy in mechanical ventilation.机械通气中的气管切开术。
Semin Respir Crit Care Med. 2014 Aug;35(4):482-91. doi: 10.1055/s-0034-1383862. Epub 2014 Aug 11.
6
Death after percutaneous dilatational tracheostomy: a systematic review and analysis of risk factors.经皮扩张气管切开术后死亡:系统评价与危险因素分析
Crit Care. 2013 Oct 29;17(5):R258. doi: 10.1186/cc13085.
7
Safety of bedside percutaneous tracheostomy in the critically ill: evaluation of more than 3,000 procedures.床边经皮气管切开术在危重症患者中的安全性:超过 3000 例操作的评估。
J Am Coll Surg. 2013 Apr;216(4):858-65; discussion 865-7. doi: 10.1016/j.jamcollsurg.2012.12.017. Epub 2013 Feb 8.
8
Percutaneous tracheostomy: to bronch or not to bronch--that is the question.经皮气管切开术:是否进入支气管——这是个问题。
J Trauma. 2011 Dec;71(6):1553-6. doi: 10.1097/TA.0b013e31823ba29e.
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Is fibreoptic percutaneous tracheostomy in ICU a breakthrough.重症监护病房中的纤维光学经皮气管切开术是一项突破吗?
J Anaesthesiol Clin Pharmacol. 2010 Oct;26(4):514-6.
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Can intensive care physicians safely perform percutaneous dilational tracheostomy? An analysis of 207 cases.重症监护医师能否安全地实施经皮扩张气管切开术?207例病例分析。
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