成人重症监护病房早期和晚期经皮气管切开术的比较

Mehmet Duran , Ruslan Abdullayev , Mevlüt Çömlekçi , Mustafa Süren , Mehmet Bülbül , Tayfun Aldemir
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引用次数: 3

摘要

背景与目的经皮气管切开术已成为重症监护室延长插管时间的一种良好选择。气管切开术的最重要的好处是患者从重症监护病房早期出院和缩短住院时间。气管内插管时间过长有喉部损伤、声带麻痹、声门及声门下狭窄、感染及气管损伤等并发症。我们研究的目的是评估重症监护室早期经皮气管切开术比晚期经皮气管切开术的潜在优势。方法对158例经皮气管切开术在重症监护病房的应用进行回顾性分析。根据经皮气管切开术前气管插管时间将患者分为早期和晚期两组。气管插管0 ~ 7d为早期气管切开组,气管插管7d后为晚期气管切开组。气管切开术部位感染患者、插管困难或潜在困难患者、18岁以下患者、呼气末正压高于10 cmH2O的患者、出血或血小板计数低于50,000 dL−1的患者不在研究范围内。记录机械通气时间和重症监护时间。结果两组患者人口学资料比较,差异无统计学意义。早期气管切开术组机械通气时间和重症监护病房时间较短,差异有统计学意义(p <0.05)。结论早期气管切开术缩短了机械通气时间和重症监护病房住院时间。因此,我们建议在被认为插管时间延长的患者早期进行气管切开术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparación de traqueotomía percutánea precoz y tardía en unidad de cuidados intensivos para adultos

Background and objectives

Percutaneous tracheotomy has become a good alternative for patients thought to have prolonged intubation in intensive care units. The most important benefits of tracheotomy are early discharge of the patient from the intensive care unit and shortening of the time spent in the hospital. Prolonged endotracheal intubation has complications such as laryngeal damage, vocal cord paralysis, glottic and subglottic stenosis, infection and tracheal damage. The objective of our study was to evaluate potential advantages of early percutaneous tracheotomy over late percutaneous tracheotomy in intensive care unit.

Methods

Percutaneous tracheotomies applied to 158 patients in adult intensive care unit have been analyzed retrospectively. Patients were divided into two groups as early and late tracheotomy according to their endotracheal intubation time before percutaneous tracheotomy. Tracheotomies at the 0-7th days of endotracheal intubation were grouped as early and after the 7th day of endotracheal intubation as late tracheotomies. Patients having infection at the site of tracheotomy, patients with difficult or potential difficult intubation, those under 18 years old, patients with positive end-expiratory pressure above 10 cmH2O and those with bleeding diathesis or platelet count under 50,000 dL−1 were not included in the study. Durations of mechanical ventilation and intensive care stay were noted.

Results

There was no statistical difference among the demographic data of the patients. Mechanical ventilation time and time spent in intensive care unit in the group with early tracheotomy was shorter and the difference was statistically significant (p < 0.05).

Conclusion

Early tracheotomy shortens mechanical ventilation duration and intensive care unit stay. For that reason we suggest early tracheotomy in patients thought to have prolonged intubation.

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