老年患者长期气管切开的并发症

Aclinical study on the main complications of prolonged tracheostomy in senlie patients

目的分析老年患者长期气管切开的并发症及其原因。方法对我院１９８２～１９９４年平均气管切开天数为５０３±４８７天的１８例老年患者进行临床、病理分析。结果主要并发症为肺部感染，用抗生素天数占气管切开天数的２９．７％；气管出血、气管套管滑脱、肺大泡也较常见；气管食管瘘、软骨环破裂等偶见。７例尸检见气管切口周围炎性水肿、上皮脱落、纤维素沉积及不同程度糜烂。结论老年患者长期气管切开的并发症主要是肺部感染、气管出血及切口周围改变等，应重视防治。

Objective\ To analyze the main omplications and causes of prolonged tracheostomy in senile patients.\ \ Methods\ From 1982 to 1994 ,18 senile patients with prolonged tracheostomies for 503±487 days on average were investigated.\ \ Results\ Main complications were infections of lungs.Days on antibiotics were 29 7% of tracheostomied days.Tracheal bleeding,tracheal cuffslipping and bullous lesions of lungs were commonly seen.Bronchoesophageal fistula,rupture of cartilage rings occasionlly happened.Circumstomal inflammation,edema,excoriation,fibrinoid deposition and erosion were found in 7 autopsied cases.\ \ Conclusions\ Main complications of prolonged tracheostomy in senile patients were pulmonaryinfections,tracheal bleeding and changes surrounding the tracheostoma.We must pay attention to complications of prolonged tracheostomy in senile patients.