在COVID-19患者中进行透皮气管切除:一项回顾性队列研究
Sofia Wagemaker Viana1, Brenda Feres1, Gabriel Roberto2
1Physician. Kursk State Medical University (KSMU), Kursk, Russia.
Sao Paulo medical journal = Revista paulista de medicina
|September 3, 2025
概括
在COVID-19患者中,早期穿皮气管切除术 (PT) 可以改善存活率并减少重症监护室 (ICU) 的停留时间. 这项研究评估了需要机械呼吸 (MV) 的重症患者的PT时间和结果.
科学领域:
- 危急护理医学
- 呼吸系统医学
- 传染性疾病
背景情况:
- 随着COVID-19大流行,医疗保健系统受到压力,机械通风 (MV) 的需求不断增加.
- 皮穿式气管切除术 (PT) 的研究旨在减少重症监护室 (ICU) 的停留时间,并优化机械通风患者的资源使用.
- 在COVID-19患者的最佳时间,安全性和治疗结果方面存在不确定性.
研究的目的:
- 描述COVID-19患者穿皮气管切除术 (PT) 的技术方面.
- 评估与PT相关的早期安全性和短期生存因素.
- 分析PT时间对重症COVID-19患者的结果的影响.
主要方法:
- 连续103名接受PT的COVID-19患者的回顾性分析 (2020年3月至6月).
- 分析的因素包括年龄,性别,PT时间,肺部参与,并发症和通风参数.
- 用单变量和多变量考克斯比例危险回归模型来确定生存预测因素.
主要成果:
- 这项研究包括103名患者,主要是男性,平均年龄为68岁.
- 常见的并发症包括高血压 (52%),糖尿病 (36%) 和心脏病 (21%).
- 在60岁以上的患者中,生存率降低了 (HR=3. 35),但在较早的PT (<10天,HR=0. 37) 和高鼻流导管使用时改善了 (HR=0. 49).
结论:
- 在特定的COVID-19患者中,早期的PT可能会减少机械通风持续时间和ICU停留时间.
- 这些研究结果表明,PT可以成为管理重症COVID-19患者的宝贵工具.
- 在疫情期间,医疗保健系统面临着严重的压力,因为呼吸机和ICU床位的短缺.
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