Hazard P B, Garrett H E, Adams J W, Robbins E T, Aguillard R N
University of Tennessee Center for the Health Sciences, Memphis.
Ann Thorac Surg. 1988 Jul;46(1):63-7. doi: 10.1016/s0003-4975(10)65854-7.
Over a 24-month period, tracheostomy was performed in 55 patients using a percutaneous, wire-guided, dilatational technique. All such procedures were undertaken at the patient's bedside in the intensive care unit, with the patient under local anesthesia and mechanically ventilated through an oral endotracheal tube. A variety of wire-guides, dilators, and tracheal tubes were used as experience and proficiency were gained with the approach, and eventually, a simple modification of a standard low-pressure cuffed endotracheal tube was found to facilitate the procedure. The percutaneous method was found to be rapid and simple, to leave almost no cosmetic deformity, and to be almost totally free from infectious complications. This technique should be considered for routine use in critically ill, ventilator-dependent patients.
在24个月的时间里，对55例患者采用经皮钢丝引导扩张技术进行了气管造口术。所有这些操作均在重症监护病房患者床边进行，患者在局部麻醉下，通过口腔气管内导管进行机械通气。随着对该方法经验的积累和熟练程度的提高，使用了各种钢丝引导器、扩张器和气管导管，最终发现对标准低压带套囊气管内导管进行简单改良有助于该操作。结果发现，经皮方法快速简便，几乎不留下任何外观畸形，且几乎完全没有感染并发症。对于依赖呼吸机的重症患者，应考虑将该技术用于常规操作。
