Liu XiaoFeng, Li Lei, Nan FuYao, Liu JiaPing, Zou Heng, Zhang Nan, Wang HongWu
Respiratory Disease Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Graduate School, Beijing University of Chinese Medicine, Beijing, China.
BMC Pulm Med. 2025 May 30;25(1):273. doi: 10.1186/s12890-025-03732-8.
Although Montgomery T-tube implantation has become an effective method for treating tracheal stenosis, the T-tube needs to be removed as a temporary treatment. At present, there is still a lack of research on the relevant factors affecting T-tube extraction. Therefore, we aimed to explore the clinical characteristics of post-tracheotomy tracheal stenosis (PTTS) disease and the risk factors affecting Montgomery T-tube extraction.
Retrospective analysis of patients who underwent Montgomery T-tube implantation in the Respiratory and Critical Care Medicine of Emergency General Hospital and the Department of Respiratory Medicine at Dongzhimen Hospital from June 2014 to September 2024. They were followed up for at least 6 months. T-tube extraction was used as the main outcome measure. A logarithmic rank test was used to analyze the association between clinical characteristics and T-tube extraction. Kaplan-Meier analysis was performed to analyze the rate of T-tube extraction. Multivariate stepwise Cox regression analysis was used to explore the variables that may affect the association of T-tube extraction.
A total of 49 patients were included, and 18 (36.7%) patients had successful extraction. In the Kaplan-Meier analysis, the rate of extubation was lower in patients with BMI ≥ 24, diabetes mellitus, and a narrow distance of less than or equal to 1 cm from the glottis (P < 0.05). In multivariate Cox regression analysis, cerebrovascular disease (HR 0.341, 95% confidence interval [CI] 0.127-0.918) and diabetes mellitus (HR 0.216, 95% confidence interval [CI] 0.049-0.959) may be independent risk factors for T-tube extraction.
Diabetes mellitus and cerebrovascular diseases are independent risk factors for T-tube extraction, and more attention should be paid to these patients in clinical practice.
This study is a retrospective observational study, and no clinical trial registration number was applied for.
尽管蒙哥马利T型管植入术已成为治疗气管狭窄的有效方法，但作为一种临时治疗手段，T型管需要取出。目前，关于影响T型管取出的相关因素仍缺乏研究。因此，我们旨在探讨气管切开术后气管狭窄（PTTS）疾病的临床特征以及影响蒙哥马利T型管取出的危险因素。
回顾性分析2014年6月至2024年9月在应急总医院呼吸与危重症医学科以及东直门医院呼吸内科接受蒙哥马利T型管植入术的患者。对他们进行至少6个月的随访。以T型管取出作为主要观察指标。采用对数秩检验分析临床特征与T型管取出之间的关联。进行Kaplan-Meier分析以分析T型管取出率。采用多因素逐步Cox回归分析探索可能影响T型管取出关联的变量。
共纳入49例患者，其中18例（36.7%）患者成功取出T型管。在Kaplan-Meier分析中，体重指数（BMI）≥24、患有糖尿病以及声门距离小于或等于1 cm的患者拔管率较低（P<0.05）。在多因素Cox回归分析中，脑血管疾病（风险比[HR] 0.341，95%置信区间[CI] 0.127 - 0.918）和糖尿病（HR 0.216，95%置信区间[CI] 0.049 - 0.959）可能是T型管取出的独立危险因素。
糖尿病和脑血管疾病是T型管取出的独立危险因素，临床实践中应更加关注这些患者。
本研究为回顾性观察性研究，未申请临床试验注册号。
