Quidaciolu F, Guasone F, Pastorino G, De Negri A, Giua R, Pesce D
Regione Liguria, USL n. 11, Sezione di Chirurgia Toracica, Ospedali Civili di Genova, Sampierdarena.
Minerva Chir. 1994 Apr;49(4):315-8.
Twenty patients undergoing lung resections were randomized into two groups: group 1 (n = 10) received mini-tracheotomy postoperatively and group 2 (n = 10) were control patients. The two groups were similarly matched in pulmonary functions (FEV1 < 1.8 1), performance status and surgical procedures (major pulmonary resections). All patients were monitored by serial chest X-ray examinations, arterial blood gases, clinical assessment and response to chest physiotherapy. Postoperative pulmonary complications of atelectasis/bronchopneumonia developed in 1 patient in group A and 4 patients in group B. Two patients of this last group required mini-tracheotomy to treat the pneumonia. The mean overall duration of mini-tracheotomy was 6.3 days. Five patients presented minor temporary symptoms related to mini-tracheotomy, including voice changes, discomfort and stridor. No long term morbidity was observed. We concluded that the use of mini-tracheotomy is safe and effective in decreasing postoperative respiratory morbidity in high risk patients.
20例行肺切除术的患者被随机分为两组：第1组（n = 10）术后接受微创气管切开术，第2组（n = 10）为对照患者。两组在肺功能（FEV1 < 1.8升）、身体状况和手术方式（主要肺切除术）方面进行了相似匹配。所有患者均通过系列胸部X线检查、动脉血气分析、临床评估以及胸部物理治疗反应进行监测。A组有1例患者发生了肺不张/支气管肺炎的术后肺部并发症，B组有4例患者发生。最后一组中有2例患者需要进行微创气管切开术来治疗肺炎。微创气管切开术的平均总持续时间为6.3天。5例患者出现了与微创气管切开术相关的轻微暂时症状，包括声音改变、不适和喘鸣。未观察到长期并发症。我们得出结论，在高危患者中使用微创气管切开术在降低术后呼吸并发症方面是安全有效的。
