口腔微血管重建中的气道管理:即时输出管是可能的吗?
John M Le1, Jordan Gigliotti2, Lior Aljadeff3
1Fellow, Division of Head and Neck Surgery, Department of Oral and Maxillofacial Surgery, University of Florida Jacksonville, Jacksonville, FL.
概括
在为口腔重建进行自由组织转移后避免气管切除术可能会减少并发症和住院时间. 与气管切开术相比,立即输出管与较少的气道问题有关,特别是在非吸烟者中.
科学领域:
- 口腔和牙面部外科手术
- 头部和部手术 头部和部手术
- 麻醉学 麻醉学
背景情况:
- 在口腔重建的自由组织转移 (FTT) 后,气管切除术很常见,但避免它可以改善恢复并减少住院时间 (LOS).
- 这项研究比较了口腔FTT患者的内内管输入与气管切除的结果.
研究的目的:
- 为了比较临床相关的结果,在口腔腔重建中进行内内管和气管切除术以进行自由组织转移.
- 评估呼吸道管理对术后并发症和医院LOS的影响.
主要方法:
- 对560名接受FTT进行口腔重建的患者进行了回顾性队列研究 (2014-2021年).
- 独立变量:外科手术期间的呼吸道管理 (内内管管道与气管切除术).
- 主要结局:术后与呼吸道有关的并发症;次要结局:LOS和手术并发症.
主要成果:
- 在立即抽管组 (n=122) 与气管切除组 (n=438) 中没有出现呼吸道并发症.
- 烟草使用与呼吸道并发症有关 (OR:2.66).
- 与气管切除术 (9天) 相比,立即输出输出管 (6.8天) 的医院LOS显著更短.
结论:
- 在FTT进行口腔重建后立即输出管与较少的呼吸道并发症和较短的LOS有关.
- 气管切除术和吸烟是这些患者术后呼吸道并发症的危险因素.
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