在心脏外科重症监护病房内进行皮肤扩张性气管切除术:单中心体验
Vignesh Vudatha1, Yahya Alwatari1, George Ibrahim2
1Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA.
Journal of chest surgery
|September 4, 2023
概括
穿皮扩展性气管切除术 (PDT) 是心脏外科重症监护室 (CSICU) 需要通风的患者的安全手术. 在CSICU患者的PDT显示出有利的结果,并发症率低,气管切除术持续时间相对较短.
科学领域:
- 心胸外科手术 心胸外科手术
- 密集护理医学 密集护理医学
- 肺部病理学 肺部病理学
背景情况:
- 相当数量的心脏手术重症监护室 (CSICU) 患者需要长时间的机械呼吸,往往需要气管切除术.
- 穿皮扩展性气管切除术 (PDT) 是这些重症患者呼吸道通道的常见方法.
研究的目的:
- 评估CSICU患者的PDT相关的长期术后结果和并发症率.
- 确定PDT后的脱和术后并发症的预测因素.
主要方法:
- 在2013年1月1日至2021年1月1日期间,在心脏,胸部或血管手术后接受PDT的CSICU患者的回顾性审查.
- 评估死亡率,脱时间和诸如出血和感染等并发症.
- 多变量回归分析以确定脱和并发症率的预测因素.
主要成果:
- 包括93名患者;70%是男性. 解锁的平均时间为39天.
- 发生了8种并发症,包括出血和中炎. 没有发现释放前脱管的显著预测因素.
- 慢性阻塞性肺病 (COPD) 是脱的负面预测因素 (HR,0.28;P=0.04).
结论:
- 穿皮扩张气管切除术 (PDT) 是在CSICU患者群体中对外科气管切除术的安全有效替代方案.
- 接受PDT的患者经历了短时间的气管切除术和较低的重大术后并发症发生率.
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