유소아 기관절개술에 대한 임상적 고찰

Abstract

Background and Objectives：Tracheotomy, although an inevitable procedure in some situations, is often avoided in pediatrics for its frequent and serious complications. So, authors studied clinical characteristics of tracheotomy as observed in pediatrics.

Materials and Methods：138 children who underwent tracheotomy during the past twenty years since 1977 were investigated. We analyzed distribution of age and gender, annual frequency, causative disorders for tracheotomy and complications.

Results：1) Number of tracheotomy performed tended to be decreased with time；2) Tracheotomy was performed two times more frequently in males than in females, and most frequently below eight years old；3) Most frequent causative disease was head injury (27.5%)；4) Most frequent indication of tracheotomy was ventilator support (49.3%)；5) The history of endotracheal intubation before tracheotomy was 86.2%；6) The complications of the tracheotomy developed in 39.9%, with the most frequent complications being granulation formation (18.1%), followed by tracheal stenosis (17.4%). 7) Frequency of late complication was relatively lower in the shorter intubation period group (22.9%) than in the longer intubation period groups (51.5% and 33.3%)；8) Late complications were lower in the group who had not been supported by a ventilator；9) Late comlications did not occurre in cases who were decannulated before 1 month.

Conclusion：We found that factors associated with complications were duration of endotracheal intubation before tracheotomy, history of ventilator care and timing of decannulation.