Li Weifei, Hu Yanjie, Hu Yan, Zhou Meng, Li Yuehua, Peng Jun
Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan, Hubei, People's Republic of China.
Int J Gen Med. 2024 Dec 19;17:6355-6365. doi: 10.2147/IJGM.S493335. eCollection 2024.
Tracheotomy has become more prevalent in clinical settings, and effectively managing postoperative complications plays a crucial role in determining patient outcomes. However, there is a scarcity of clinical research focusing on the development of intratracheal granuloma after tracheotomy, and there is insufficient theoretical support for early detection in clinical settings. This study investigates the relationship between clinical factors and the occurrence and location of intratracheal granuloma.
Clinical parameters from 872 patients who underwent tracheotomy between January 1, 2010, and December 30, 2018, were collected from the Hospital Information System. A retrospective analysis was conducted, focusing on factors such as age, gender, smoking history, comorbidities, primary lesion location, benign versus malignant primary disease, pulmonary infection, duration of tracheal intubation prior to tracheotomy, surgical method and other factors.
Intratracheal granuloma was observed in 50 (5.73%) cases of all tracheotomy patients. Factors such as smoking history, primary lesion location, and pulmonary infection were associated with the occurrence of intratracheal granuloma. Additionally, multivariate logistic regression identified smoking, pulmonary disease and pulmonary infection as independent risk factors for the development of intratracheal granuloma following tracheotomy. Regarding the location of the granuloma, 42 cases (84%) were found in the proximal trachea, while the remaining cases were located in the distal trachea. Univariate analysis indicated that age, gender, smoking history, and primary lesion location were related to the location of intratracheal granuloma. The median interval between the detection of intratracheal granuloma and tracheotomy was 52 days.
Considering the occurrence and location of intratracheal granulomas following tracheotomy, along with the associated risk factors outlined above, it is imperative that clinicians give these issues due attention in practice. Furthermore, approximately 50% of intratracheal granulomas develop within 52 days post-tracheotomy, offering valuable insights for clinicians in formulating effective follow-up strategies.
气管切开术在临床环境中已变得更为普遍,有效管理术后并发症对决定患者预后起着关键作用。然而,针对气管切开术后气管内肉芽肿形成的临床研究匮乏,且临床环境中早期检测缺乏足够的理论支持。本研究调查临床因素与气管内肉芽肿的发生及位置之间的关系。
从医院信息系统收集2010年1月1日至2018年12月30日期间接受气管切开术的872例患者的临床参数。进行回顾性分析,重点关注年龄、性别、吸烟史、合并症、原发病变位置、原发性疾病的良恶性、肺部感染、气管切开术前气管插管时间、手术方法等因素。
在所有气管切开术患者中,有50例(5.73%)观察到气管内肉芽肿。吸烟史、原发病变位置和肺部感染等因素与气管内肉芽肿的发生有关。此外,多因素逻辑回归确定吸烟、肺部疾病和肺部感染是气管切开术后气管内肉芽肿形成的独立危险因素。关于肉芽肿的位置,42例(84%)位于气管近端,其余病例位于气管远端。单因素分析表明年龄、性别、吸烟史和原发病变位置与气管内肉芽肿的位置有关。气管内肉芽肿检测与气管切开术之间的中位间隔时间为52天。
考虑到气管切开术后气管内肉芽肿的发生及位置,以及上述相关危险因素,临床医生在实践中必须对这些问题给予应有的关注。此外,约50%的气管内肉芽肿在气管切开术后52天内形成,这为临床医生制定有效的随访策略提供了有价值的见解。