Van Heerden P V, Webb S A, Power B M, Thompson W R
Department of Intensive Care, Sir Charles Gairdner Hospital, Perth, Western Australia.
Anaesth Intensive Care. 1996 Feb;24(1):56-9. doi: 10.1177/0310057X9602400110.
Percutaneous dilational tracheostomy (PDT), first described in the 1950s, has become a common bedside technique in the Intensive Care Unit (ICU). This study compares the early complications associated with the use of the Ciaglia PDT (Cook Critical Care, Bloomington, USA) technique, with the newly available Portex PDT technique (Portex Ltd., UK). The Ciaglia technique was adopted in this ICU in July 1994 and twenty-nine patients had a tracheostomy using this set until January 1995. Complications during the procedure were collected prospectively. When the Portex PDT set became available in January 1995, it was decided to assess the complication rate of this technique and compare them to the previously-collected data using the Ciaglia PDT set. Twenty-five patients have had a tracheostomy using the Portex PDT set. There has been no mortality associated with either PDT set. Bleeding requiring intervention occurred in two patients in the Ciaglia group and three patients in the Portex Group. All these patients had a bleeding diathesis. Loss of airway control occurred on one occasion in the Ciaglia group due to premature removal of the endotracheal tube. The first routine tracheostomy tube change at day 7 was complicated in four cases in the Ciaglia group. One infected stoma was noted in the Ciaglia group at day 7. Both techniques result in rapid, safe placement of a tracheostomy tube in critically ill patients in the ICU, obviating the need for surgical referral and transport to the operating room.
经皮扩张气管切开术（PDT）于20世纪50年代首次被描述，现已成为重症监护病房（ICU）常见的床边操作技术。本研究比较了使用Ciaglia PDT（美国布卢明顿库克重症护理公司）技术与新推出的Portex PDT技术（英国Portex有限公司）相关的早期并发症。1994年7月该ICU采用了Ciaglia技术，截至1995年1月有29例患者使用该套件进行了气管切开术。术中并发症是前瞻性收集的。1995年1月Portex PDT套件可用后，决定评估该技术的并发症发生率，并将其与之前使用Ciaglia PDT套件收集的数据进行比较。有25例患者使用Portex PDT套件进行了气管切开术。两种PDT套件均未导致死亡。Ciaglia组有2例患者、Portex组有3例患者发生了需要干预的出血。所有这些患者均有出血倾向。Ciaglia组有1次因过早拔除气管内导管导致气道控制丧失。Ciaglia组在第7天首次常规更换气管切开管时，有4例出现并发症。Ciaglia组在第7天发现1例造口感染。两种技术都能在ICU的重症患者中快速、安全地置入气管切开管，无需转诊至外科并送往手术室。
