Petros S, Engelmann L
Abteilung für Intensivmedizin, Universität Leipzig, Germany.
Intensive Care Med. 1997 Jun;23(6):630-4. doi: 10.1007/s001340050385.
To evaluate the safety of percutaneous dilatational tracheostomy.
A prospective clinical study.
The intensive care unit of a university medical clinic.
137 critically ill patients admitted between May 1993 and September 1996.
Percutaneous dilatational tracheostomy at the bedside.
The median duration of translaryngeal intubation prior to tracheostomy was 8 days. Tracheostomy was carried out within 12.8 min (range 7-30 min). Acute complications were documented in 11.0% of the patients. There was one case of severe bleeding with transient asphyxia. Four patients had tracheal mucosal laceration treated conservatively. The postoperative in-hospital complication rate was 5.1%, the sole problem being stomal bleeding. Only two cases of stomal infection were documented. There was no procedure-related mortality.
In the hands of the experienced, percutaneous dilatational tracheostomy is a safe and quick bedside procedure. It is also less expensive and incurs minimal stress for the patient compared with the surgical method. The technique can be easily mastered by non-surgical physicians and we feel that it is the method of choice for elective tracheostomy in the majority of intensive care patients.
评估经皮扩张气管切开术的安全性。
一项前瞻性临床研究。
一所大学医学诊所的重症监护病房。
1993年5月至1996年9月期间收治的137例重症患者。
在床边进行经皮扩张气管切开术。
气管切开术前经喉插管的中位持续时间为8天。气管切开术在12.8分钟内完成（范围7 - 30分钟）。11.0%的患者记录有急性并发症。有1例严重出血伴短暂窒息。4例气管黏膜撕裂伤采用保守治疗。术后院内并发症发生率为5.1%，唯一问题是造口出血。仅记录到2例造口感染。无手术相关死亡病例。
在经验丰富者手中，经皮扩张气管切开术是一种安全、快速的床边操作。与手术方法相比，它成本更低，对患者造成的应激也最小。非外科医生可轻松掌握该技术，我们认为它是大多数重症监护患者择期气管切开术的首选方法。
