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.
李杨, 张立朋, 李强, 鲁迪, 张惠军, 谷智明. 神经重症患者经皮气管切开与常规气管切开效果比较[J]. 武警医学, 2021, 32(3): 228-230.
LI Yang, ZHANG Lipeng, LI Qiang, LU Di, ZHANG Huijun, GU Zhiming. A comparison between percutaneous dilatational versus open surgical tracheostomy in neurocritical care patients. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(3): 228-230.
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.
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.
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.
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