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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Tracheotomy in very low birth weight neonates: indications and outcomes.
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Tracheotomy in very low birth weight neonates: indications and outcomes.

机译：极低出生体重新生儿气管切开术：适应症和预后。

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OBJECTIVE/HYPOTHESIS: To review incidence of, indications for, and outcomes of tracheotomy in very low birth weight (VLBW) infants. STUDY DESIGN: Retrospective review in tertiary care hospital. METHODS: Eighteen VLBW (<1,500 g) infants with bronchopulmonary dysplasia undergoing tracheotomy in the neonatal intensive care unit between October 1997 and June 2002 were studied. Controls consisted of 36 VLBW infants undergoing intubation without tracheotomy, two per study infant, matched by gestational age and weight. Outcome measures included duration and number of intubation events, time to decannulation, complications, comorbidities, length of stay, and speech, language, and swallowing measures. RESULTS: Infants undergoing tracheotomy had an average duration of intubation of 128.8 days with a median number of 11.5 intubation events, both significantly greater than those of controls. Percentage of those with laryngotracheal stenosis was 44% of study infants had laryngotracheal stenosis compared to 1.6% in all intubated VLBW infants. The tracheotomy group had a significantly higher incidence of gastroesophageal reflux, pulmonary hypertension, and gastrostomy tube placement. The overall tracheotomy-related complication rate was 38.9%. Three were lost to follow-up, and five deaths occurred, two possibly tracheotomy-related. Six of ten were decannulated by an average time of 3.8 years, two of six after laryngotracheal reconstruction. Four of ten remained cannulated for a variety of reasons. Disorders of speech, language, and swallowing were common. CONCLUSIONS: When considering tracheotomy in VLBW infants, the total number of intubation events should be monitored as well as the total duration of intubation. The relatively high incidence of laryngotracheal stenosis argues for earlier endoscopy and possibly earlier tracheotomy in infants with developing stenoses.
机译：目的/假设：回顾极低出生体重（VLBW）婴儿气管切开术的发生率，适应症和预后。研究设计：在三级医院进行回顾性审查。方法：对1997年10月至2002年6月在新生儿重症监护室进行气管切开术的18例VLBW（<1,500 g）婴儿进行了气管切开术。对照组由36例未行气管切开插管的VLBW婴儿组成，每个研究婴儿2例，根据胎龄和体重进行匹配。结果测量包括插管事件的持续时间和次数，拔管的时间，并发症，合并症，住院时间以及言语，语言和吞咽措施。结果：接受气管切开术的婴儿平均插管持续时间为128.8天，中位数为11.5次插管事件，两者均显着大于对照组。喉气管狭窄的比例为研究婴儿患有喉气管狭窄的比例为44％，而所有插管的VLBW婴儿为1.6％。气管切开术组的胃食管反流，肺动脉高压和胃造瘘管放置的发生率明显更高。总体气管切开术相关并发症的发生率为38.9％。 3例失访，5例死亡，2例可能与气管切开术有关。十个中的六个在平均3.8年的时间里没有进行气管切开，喉气管重建后的六个中有两个。出于各种原因，十个中的四个仍处于插管状态。言语，语言和吞咽障碍都很常见。结论：在考虑对VLBW婴儿进行气管切开术时，应监测插管事件的总数以及插管的总时间。喉气管狭窄的发生率相对较高，这提示患有狭窄狭窄的婴儿应更早进行内窥镜检查，并可能更早进行气管切开术。

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