儿科气管切除术解管:有什么证据?
Tiffany Raynor1, Joshua Bedwell
1Texas Children's Hospital, Houston, TX, USA.
Current opinion in otolaryngology & head and neck surgery
|September 26, 2023
概括
儿科解需要一个逐步的方法. 缺乏基于证据的指导方针,但协议通常包括呼吸道评估,封闭试验和管道缩小,以安全地切除儿童的气管切除术.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 儿科呼吸系统医学 儿科呼吸系统医学
- 儿科重症监护 儿科重症监护
背景情况:
- 儿科气管切除术在医疗复杂的儿童中很常见,但断管切除可能具有挑战性.
- 无法脱导致严重的发病率和死亡率.
- 缺乏基于证据的指导方针,用于小儿气管管切除术.
研究的目的:
- 审查过去10年出版的儿科脱协议.
- 识别脱化策略中的共同元素和变异.
- 突出需要进一步研究和标准化的领域.
主要方法:
- 对过去十年出版的脱协议的审查.
- 对常见实践的分析,包括气道评估,管改造和封顶试验.
- 检查脱后的观察期和气管皮质管的管理.
主要成果:
- 在脱之前,内镜气道评估至关重要.
- 大多数协议都建议缩小气管切除管的大小,并进行封闭试验.
- 在监控的环境中,在一夜之间设置上限是常见的,在解封后24-48小时的观察期.
- 持续的气管皮质囊是常见的;手术切除与二次意图愈合是有效的.
- 关于被限制的多睡眠学 (PSG) 的实用性和资源影响存在争论.
结论:
- 儿科脱应该是一个逐步的过程.
- 协议应该是安全的,方便的和资源意识的.
- 机构协议对于持续的护理和质量改善至关重要.
- 需要进一步的研究来确定PSG的患者选择标准.
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