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小儿烧伤患者的气管切开术

Tracheostomy in the young pediatric burn patient.

作者信息

Coln C E, Purdue G F, Hunt J L

机构信息

The University of Texas Southwestern Medical Center at Dallas, 75235-9158, USA.

出版信息

Arch Surg. 1998 May;133(5):537-9; discussion 539-40. doi: 10.1001/archsurg.133.5.537.

Abstract

OBJECTIVE

To evaluate the incidence of complications in comparison with the benefits of tracheostomy in young pediatric burn patients (newborn to 3 years old).

DESIGN

Retrospective survey.

SETTING

Tertiary care burn center.

PATIENTS

A total of 1549 consecutive pediatric burn patients, of whom 180 were intubated.

INTERVENTIONS

Tracheostomy was performed in 76 children.

MAIN OUTCOME MEASURES

Duration of mechanical ventilation, mortality, respiratory complications, airway complications, and condition of the airway at discharge from the hospital.

RESULTS

Seventy-six patients required tracheostomy. Their mean burn size was 34% total body surface area and mean length of stay in the hospital was 56 days. There were no perioperative complications. Eight patients (10%) could not be decannulated because of airway obstruction. Five of these outgrew their obstruction, 2 required surgery, and 1 continues to be evaluated for laryngeal reconstruction.

CONCLUSION

Pediatric tracheostomy can be performed safely with no perioperative complications and acceptable chronic morbidity.

摘要

目的

评估小儿烧伤患者(新生儿至3岁)气管切开术的并发症发生率及其益处。

设计

回顾性调查。

地点

三级烧伤护理中心。

患者

共1549例连续性小儿烧伤患者,其中180例进行了插管。

干预措施

76名儿童接受了气管切开术。

主要观察指标

机械通气时间、死亡率、呼吸并发症、气道并发症以及出院时气道状况。

结果

76例患者需要气管切开术。他们的平均烧伤面积为全身表面积的34%,平均住院时间为56天。无围手术期并发症。8例患者(10%)因气道阻塞无法拔管。其中5例长大后气道阻塞自行缓解,2例需要手术治疗,1例仍在接受喉重建评估。

结论

小儿气管切开术可安全进行,无围手术期并发症,慢性发病率可接受。

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