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危重症患者实时超声引导下经皮气管切开术与外科气管切开术的比较

Comparison Between Real-Time Ultrasound-Guided Percutaneous Tracheostomy and Surgical Tracheostomy in Critically Ill Patients.

作者信息

Kang Hyun Tag, Kim Shin Young, Lee Min Ki, Lee Seung Won, Baek Aerin, Park Ki Nam

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University, Bucheon, Republic of Korea.

Department of Internal Medicine, Soonchunhyang University, Bucheon, Republic of Korea.

出版信息

Crit Care Res Pract. 2022 Sep 25;2022:1388225. doi: 10.1155/2022/1388225. eCollection 2022.

Abstract

BACKGROUND

Ultrasound-guided percutaneous dilatational tracheostomy (US-PDT) has been adapted for use in intensive care units (ICU). US-PDT is comparable to bronchoscopy-assisted tracheostomy. However, compared to surgical tracheostomy (ST), its safety and effectiveness have not been well studied.

OBJECTIVES

To determine the efficacy and safety of US-PDT compared to ST.

MATERIALS AND METHODS

A total of 90 patients who underwent US-PDT ( = 36) or ST ( = 54) between July 2019 and September 2020 were enrolled. US-PDT was performed in the ICU without a surgical assistant or bronchoscope. Data were collected retrospectively and analyzed regarding clinical characteristics, procedure times and details, complications, and mortality rate.

RESULTS

The success rate of US-PDT was 97.4% and the procedure time was shorter than ST (5.2 ± 3.1 vs. 10.5 ± 5.0 min). There were no significant differences in clinical characteristics and procedure details. There was no procedure-related mortality in either of the groups.

CONCLUSIONS

US-PDT is time-efficient and as safe as ST. Based on our results, US-PDT may be considered a potential alternative to ST in high-risk patients and in those who cannot be transported.

摘要

背景

超声引导下经皮扩张气管切开术(US-PDT)已适用于重症监护病房(ICU)。US-PDT与支气管镜辅助气管切开术相当。然而,与外科气管切开术(ST)相比,其安全性和有效性尚未得到充分研究。

目的

确定US-PDT与ST相比的疗效和安全性。

材料与方法

纳入2019年7月至2020年9月期间共90例行US-PDT(n = 36)或ST(n = 54)的患者。US-PDT在ICU进行,无需手术助手或支气管镜。回顾性收集数据并分析临床特征、手术时间和细节、并发症及死亡率。

结果

US-PDT的成功率为97.4%,手术时间短于ST(5.2±3.1 vs. 10.5±5.0分钟)。临床特征和手术细节无显著差异。两组均无手术相关死亡。

结论

US-PDT省时且与ST一样安全。基于我们的结果,US-PDT可被视为高危患者和无法转运患者ST的潜在替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ee1/9527437/b4ceb518b1f6/CCRP2022-1388225.001.jpg

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