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成年危重症患者经皮扩张气管切开术与传统外科气管切开术的对比研究

Comparative Study of Percutaneous Dilatational Tracheostomy and Conventional Surgical Tracheostomy in Critically Ill Adult Patients.

作者信息

Pandit Ankush, Swami Gautam, Kumar K Dilip

机构信息

Department of ENT, Nootan Medical College and Research Centre, Visnagar, Mehsana, Gujarat 384315 India.

Department of ENT, GS Medical College, Pilkhuwa, Hapur, Uttar Pradesh 245304 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):1568-1572. doi: 10.1007/s12070-023-03666-9. Epub 2023 Mar 16.

Abstract

The present study was aimed to compare percutaneous dilatational tracheostomy (PDT) with that of conventional surgical tracheostomy (ST) in critically ill adult patients requiring tracheostomy for respiratory management. For this purpose 32 critically ill patients, admitted to the ICU between July 2016 and June 2018, were subjected to tracheostomy and randomly divided into two groups (PDT and ST) of 16 patients each. Mean duration of intubation was similar between the two procedures while the mean size of the tracheostomy tube was smaller in percutaneous technique. In comparison, post-operative infection after 7 days seem to be statistically lowered and the length of scar tend to be smaller in PDT patients. Although early and late post-operative complication rates are not statistically significant in the PDT groups, yet investigations of the long-term outcome following PDT are, therefore, necessary. Generally, PDT has lower acute complications than ST, although this may vary by the specific PDT technique. Patient factor may also influence complications. In view of the benefit versus risks in tracheostomy, PDT may be considered the "procedure of choice" for performing elective tracheostomies in critically ill adult patients.

摘要

本研究旨在比较经皮扩张气管切开术(PDT)与传统外科气管切开术(ST)在因呼吸管理需要进行气管切开术的成年重症患者中的应用。为此,选取了2016年7月至2018年6月期间入住重症监护病房(ICU)的32例重症患者进行气管切开术,并随机分为两组(PDT组和ST组),每组16例。两种手术的平均插管时间相似,但经皮技术中气管切开管的平均尺寸较小。相比之下,PDT组患者术后7天的感染率在统计学上似乎较低,且瘢痕长度往往较小。尽管PDT组术后早期和晚期并发症发生率在统计学上无显著差异,但因此有必要对PDT后的长期结果进行研究。一般来说,PDT的急性并发症比ST少,尽管这可能因具体的PDT技术而异。患者因素也可能影响并发症。鉴于气管切开术的益处与风险,PDT可被视为成年重症患者进行选择性气管切开术的“首选手术”。

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Tracheotomy: timing and techniques.气管切开术:时机与技术
Curr Opin Otolaryngol Head Neck Surg. 2003 Dec;11(6):473-9. doi: 10.1097/00020840-200312000-00012.

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