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A comparison between percutaneous dilatational versus open surgical tracheostomy in neurocritical care patients |
LI Yang, ZHANG Lipeng, LI Qiang, LU Di, ZHANG Huijun, GU Zhiming |
Department of Intensive Care, Beijing Municipacl Corps Hospital of PAP, Beijing 100027,China |
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Abstract Objective To explore the clinical value of percutaneous tracheostomy in neuro critically ill patients. Methods The clinical data on 69 cases of neurocritical illness admitted to our hospital between January 2015 and May 2018 was retrospectively analyzed. According to treatments, these patients were divided into two groups: the PDT group (percutaneous dilatational tracheostomy, n=48) and ST group (open surgical tracheostomy, n=21). The clinical features, duration of surgery , bleeding volume, hemodynamics , intracranial pressure(ICP) and complications were compared between the two groups and statistically analyzed. Results There was significant difference in duration of surgery[(7.1±1.5)min vs. (13.5±4.9)min]between the two groups, but there was no significant difference in intracranial pressure fluctuation or hemodynamic indexes. Conclusions There is no significant difference between ST and PDT in hemodynamics or intracranial pressure among neurocritical patients, but surgery takes less time with PDT. It should be the first option for neurocritical care patients.
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Received: 10 October 2020
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[1] |
Lerner A D, Yarmus L. Percutaneous dilational tracheostomy [J]. Clin Chest Med, 2018, 39(1): 211-222.
|
[2] |
Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy. A new simple bedside procedure; preliminary report [J]. Chest, 1985, 87(6): 715-719.
|
[3] |
翟 翔, 张金玲, 何京川, 等. 经皮旋转扩张气管切开术安全性的大宗病例研究 [J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(03): 176-178.
|
[4] |
Johnson S, Velikovic A, Javidnia H. Complication rates of open surgical versus percutaneous tracheostomy in critically ill patients [J]. Laryngoscope, 2016, 126(11): 2459-2467.
|
[5] |
Oggiano M, Ewig S, Hecker E. A comparison of percutaneous dilatational tracheostomy versus conventional surgical tracheostomy [J]. Pneumologie, 2014, 68(5): 322-328.
|
[6] |
Shathri Z, Susanto I. Percutaneous tracheostomy [J]. Semin Respir Crit Care Med, 2018, 39(6): 720-730.
|
[7] |
郑仕奇, 王 刚, 刘建鑫, 等. 经皮扩张钳与常规气管切开在重症脑血管病患者的应用比较 [J]. 中华临床医师杂志(电子版), 2012, 6(18): 5701-5702.
|
[8] |
陈 通, 金玉兰, 付爱军, 等. 经皮气管切开术与传统气管切开术在神经重症患者救治中安全性的单中心随机对照研究 [J]. 河北医药, 2014, 36(13):2003-2005.
|
[9] |
熊学辉, 魏小川, 罗 杰, 等. 经皮气管切开术在神经外科急危重症病人中的应用体会 [J]. 中国临床神经外科杂志, 2019, 5(24): 312-313.
|
[10] |
Kieninger M, Windorfer M, Eissnert C, et al. Impact of bedside percutaneous dilational and open surgical tracheostomy on intracranial pressure, pulmonary gas exchange, and hemodynamics in neurocritical care patients [J]. Medicine, 2019, 98(35): e17011.
|
[11] |
孙海欣, 王文志. 中国60万人群脑血管病流行病学抽样调查报告 [J]. 中国现代神经疾病杂志, 2018, 18(2): 83-88.
|
[12] |
Khandelawal A, Kapoor I, Goyal K, et al. Pneumothorax during percutaneous tracheostomy-a brief review of literature on attributable causes and preventable strategies [J]. Anaesthesiology Intensive Ther, 2017, 49(4): 317-319.
|
[13] |
UlatowskiN, Karolak W, Los A, et al. Iatrogenic aortic arch injury after unsuccessful percutaneous tracheostomy [J]. Card Surg, 2020, 1(3):1-3.
|
|
|
|