頁籤選單縮合
題名 | 床側之氣管切開術=Bedside Tracheotomy |
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作者姓名(中文) | 劉時安; 許振益; 游進益; | 書刊名 | 中華民國耳鼻喉科醫學雜誌 |
卷期 | 36:4 民90.07-08 |
頁次 | 頁225-229 |
分類號 | 416.2151 |
關鍵詞 | 床側氣管切開術; Bedside tracheotomy; |
語文 | 中文(Chinese) |
中文摘要 | 背景:氣管一切開術乃一古老之手術,其適應症有很多,現在則常用於長期插管之病人。為了辟免併發症發生,以及燈光、器械等因素之考量,氣管切開術大部份要到開刀房中進行,本篇之目的在於提出本科對於床側氣管開術之經驗,討論其優缺點,進而探討是否會有較高之手術併發症。 方法:1996年9月側1999年8月接受氣管切開術之病人共有217例,其中有34例是在床側進行,分析其過去病史、手術適應症、術中及術後併發症。 結果:其中男性21名,女性13名,平均年齡63.6歲。26名病人是因為長期插管,而其他8名則為上呼吸道阻塞。22例在普通病房,12例在加護中心。無手術死亡病例及術中之併發症。術後主要併發症有2例(5.8%),分別為出血及氣胸,次要併發症有1例(2.9%),為傷口感染。 結論:對於重症病人而言,床側之氣管切開手術不失為一安全、方便、經濟之方法。它避免運送病人中潛在性之危險,節省麻醉部門之人力資源,讓手術室能夠得到更有效率之運用。 |
英文摘要 | BACKGROUND: Tracheotomy is one of the oldest surgical procedures and is used in place of prolonged endotracheal tube intubations. The procedure is usually performed in the operating room to minimize complications. We present our experiences with and analyze our data from bedside tracheotomies to assess relative complication rates. METHODS: Since September 1996, we have been performing bedside open tracheotomies. The surgical procedure was the same as that used in theatre except that it used local anesthesia. Surgical indications and early complications were recorded and analyzed. RESULTS: Up to August 1999, a total of 34 patients underwent the bedside procedure, while another 183 patients had tracheotomies in theatre. In total, there were 21 men and 13 women. Their ages ranged between 15 and 96 years with a mean age of 36.6 years. In 26 cases, the procedure was performed because of long-term intubation, and the other eight were performed for impending upper airway obstruction. No peri-operative morbidity or mortality was noted. Major complications infection was seen in only one patient (2.9%). CONCLUSION: Bedside tracheotomy is safe, convenient, and cost-effective procedure for critical patients requiring long-term intubation and in those who require establishment of an airway but are difficult to intubate. The risks associated with transportation from the ward to the operating room are also avoided, and the complication rate of 5.8% is acceptable. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。