Objective To study the clircal characteristics of elderly tracheotomies performed at a tertiary referral center.Methods A retrospective review of hospital records from July 2008 to March 2010 was conducted to assess 73 aged patients who had undergone tracheotomies.Results A total of 73 tracheotomies were performed on patients over 70 years.Long-term mechanical ventilation was the primary indication for tracheotomy ( n = 71,97.3％ ).Lesser number of patients ( n = 22.7％ ) required tracheotomy for upper airway obstruction.The majority of procedures were performed on the 7th day of mechanical ventilation.In some cases (n =52, 71.2％ ), complicated neck anatomy were encountered, including morbid obesy, a short and thick neck, cervical stiffness, thyroid gland tumors.Individualized surgery should be performed in difficult condition.Total complication rate was 18％ ,including stoma bleeding(6.8％ ) and subcutaneous emphysema(4.1％ ).Conclusions The majority of tracheotomy are performed due to prolonged ventilation, neck anatomy is common in elderly patients.Individualized procedure could reduce complication rate of tracheotomies in the elderly.%目的 研究老年病人气管切开术的临床特点.方法对73例年龄>70岁的老年病人的气管切开术进行回顾分析.对施行气管切开术的手术原因、手术时机、手术方式、手术条件及手术后并发症进行统计.结果长期气管插管为老年病人施行气管切开术的主要原因,喉梗阻为次要原因,手术时机在气管插管后7 d为主,复杂手术条件者在老年病人中占有较大比例(71.2%),针对这些病人的手术方式有别于普通人群,手术后并发症有伤口出血(6.8%)、皮下气肿(4.1%).结论老年病人的气管切开术以长期气管插管病人为主,手术时机提前,老年病人气管切开术遇到的复杂条件较多,可采用个性化的手术方案,手术后并发症发生率较低.
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