Toursarkissian B, Zweng T N, Kearney P A, Pofahl W E, Johnson S B, Barker D E
Department of Surgery, University of Kentucky Chandler Medical Center, Lexington 40536-0084.
Ann Thorac Surg. 1994 Apr;57(4):862-7. doi: 10.1016/0003-4975(94)90191-0.
Tracheostomy is indicated frequently in the treatment of critically ill patients who require prolonged mechanical ventilation. The purpose of this prospective study was to evaluate our initial experience with 141 cases of percutaneous dilational tracheostomy (PDT) performed over a 2-year period. One hundred twenty PDTs (85%) were placed at the bedside, and 21 (15%) were performed in the operating room in conjunction with other procedures. The procedural complication rate was 11% (16 of 141). Most complications were easily recognized and did not preclude the completion of PDT. One death occurred secondary to severe bronchospasm. The postoperative complication rate was 8% (11 of 141). The most frequent complication was peristomal oozing. The average duration of follow-up after decannulation for patients discharged alive and decannulated was 36 +/- 27 weeks. There were 3 recognized cases of clinically symptomatic tracheal stenosis. We conclude that PDT is comparable with the open method and can be performed rapidly and safely at the patient's bedside.
气管切开术常用于需要长期机械通气的重症患者的治疗。这项前瞻性研究的目的是评估我们在两年内对141例经皮扩张气管切开术（PDT）的初步经验。120例（85%）PDT在床边进行，21例（15%）在手术室与其他手术同时进行。手术并发症发生率为11%（141例中的16例）。大多数并发症易于识别，并不妨碍PDT的完成。1例死亡继发于严重支气管痉挛。术后并发症发生率为8%（141例中的11例）。最常见的并发症是造口周围渗血。存活并拔管患者拔管后的平均随访时间为36±27周。有3例经确认的临床症状性气管狭窄病例。我们得出结论，PDT与开放手术方法相当，可在患者床边快速、安全地进行。
