Schlessel J S, Harper R G, Rappa H, Kenigsberg K, Khanna S
Department of Pediatrics, North Shore University Hospital-Cornell University Medical College, Manhasset, NY 11030.
J Pediatr Surg. 1993 Jul;28(7):873-6. doi: 10.1016/0022-3468(93)90685-e.
Thirty-six very low birth weight premature infants (VLBW-PT) born at 24 to 32 weeks gestation and with birth weights 635 to 1,360 g who had tracheostomies performed for acquired subglottic stenosis or for prolonged mechanical ventilation were followed in relation to acute and long-term mortality and morbidity. Mortality due to the tracheostomy occurred in 4 patients (11%); mortality from all other causes was 25%. Death after hospital discharge was associated with the nonuse of prescribed cardiorespiratory monitors. Complications < 1 week postsurgery occurred in 31% of infants and complications > or = 1 week postsurgery occurred in 64% of infants. Fifty percent of infants required tracheostomy for > 2 years and/or extensive reconstructive surgery of the airway. Parents should be counselled that VLBW-PT infants with a tracheostomy may require extended medical and home care. An effective home care program requires parental training in tracheostomy care, the use of ancillary equipment, and infant cardiopulmonary resuscitation.
对36例孕周为24至32周、出生体重为635至1360克的极低出生体重早产儿（VLBW-PT）进行了随访，这些患儿因获得性声门下狭窄或长期机械通气而接受了气管切开术，随访内容包括急性和长期死亡率及发病率。因气管切开术导致的死亡发生在4例患者中（11%）；所有其他原因导致的死亡率为25%。出院后死亡与未使用规定的心肺监护仪有关。术后<1周出现并发症的婴儿占31%，术后≥1周出现并发症的婴儿占64%。50%的婴儿需要气管切开术超过2年和/或进行广泛的气道重建手术。应告知家长，接受气管切开术的VLBW-PT婴儿可能需要长期的医疗和家庭护理。有效的家庭护理计划需要对家长进行气管切开术护理、辅助设备使用及婴儿心肺复苏方面的培训。
