在COVID-19患者中,开放式或穿皮式气管切除术:回顾性队列分析
Alejandro González-Muñoz1,2, Camilo Ramírez-Giraldo3,4,5, Jorge David Peña Suárez1,2
1Surgery Department, Hospital Universitario Mayor-Méderi, Bogotá, Colombia.
BMC pulmonary medicine
|August 22, 2023
概括
穿皮气管切除术与需要长时间机械通风 (MV) 的COVID-19患者的住院死亡率显著降低有关. 这项研究表明,穿皮气管切除术是首选的方法,而不是开放式气管切除术,以获得更好的患者结果.
科学领域:
- 关键护理医学 关键护理医学
- 手术手术手术手术手术手术手术手术手术手术
- 传染性疾病 传染性疾病
背景情况:
- 由于COVID-19的流行,机械通风 (MV) 的使用增加了.
- 气管切除术对于从MV中难以断奶的患者至关重要.
- 据报道,开放式和穿皮式气管切除术的结果是相互矛盾的.
研究的目的:
- 为了比较COVID-19患者的开放式和穿皮式气管切除术的临床结果.
- 确定长期MV的COVID-19患者的最佳气管切除术技术.
主要方法:
- 对113名需要MV和气管切除的COVID-19患者进行回顾性队列研究.
- 开放式和穿皮式气管切除组之间的住院死亡率的比较.
- 多变量分析以确定死亡率的独立风险因素.
主要成果:
- 穿皮气管切除术 (35.4%) 与开放气管切除术 (64.6%,65.7%的死亡率) 相比,在医院内死亡率显著降低 (25%).
- 开放式气管切除术,年龄较大和较高的APACHE II分数是死亡率的独立风险因素.
- 晚期气管切除术和手术内氧化与死亡率无关.
结论:
- 穿皮气管切除术与COVID-19患者的医院死亡率降低有关.
- 透皮气管切割应该被认为是COVID-19患者的主要手术选择,这些患者需要延长MV或面临断奶困难.
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