不能输管,不能提供氧气吗? 最喜欢的外科手术策略是什么? 一个回顾性分析
Akiva Nachshon1, Shimon Firman1, Baruch Mark Batzofin1
1General Intensive Care Unit, Department of Anesthesiology, Critical Care and Pain Medicine Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel.
皮肤扩展性气管切除术 (PDT) 在"无法输管,无法氧化或通风" (CICOV) 紧急情况中显示出更高的初始成功率和更低的死亡率. 对于不经常使用者来说,甲状腺切除术 (CTM) 可能更好.
科学领域:
- 紧急医疗 紧急医疗
- 手术气道管理手术气道管理
- 关键的护理关键的护理
背景情况:
- 甲状腺切除术 (CTM) 是推的紧急手术呼吸道手术.
- 危及生命的呼吸道紧急情况,称为"不能输管,不能氧化或通风" (CICOV),需要迅速干预呼吸道.
- 替代技术正在不断评估,以改善患者的治疗结果.
研究的目的:
- 在CICOV情况下,比较皮革扩张气管切除术 (PDT) 与CTM的结果.
- 评估PDT的有效性和安全性,作为CTM在紧急气道管理中的替代方案.
主要方法:
- 追溯分析33个CICOV病例,12个PDT和21个CTM.
- 首次成功率,术后并发症,死亡率和长期结果的比较.
- 记录了患者的人口统计和程序学家的经验.
主要成果:
- PDT最初的成功率为100%,而CTM的成功率为86%.
- 与PDT没有报告任何术后并发症,与CTM不同,CTM有假通道和出血.
- PDT组没有立即死亡率,而CTM在24小时内有5/19例死亡. 此外,PDT也显示出更好的从机械通风中解放出来.
结论:
- 当经验丰富的从业者进行时,PDT是CICOV的可行的临床选择.
- 对于临床医生来说,CTM仍然是一个不太经常接触CICOV场景的合适选择.
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