長期使用呼吸器患者早期氣切較晚期氣切效益探討

Early Versus Late Tracheostomy for Long-tern Mechanical Ventilation Patient

林曉佩(Hsiao-Pei Lin) ； 陳嘉銘(Chia-Ming Chen) ； 許淑純(Shu-Chun Hsu) ； 陳怡均(Yi-Chun Chen)

《醫學與健康期刊》 2卷1期附冊 (2013/09) Pp. 21-29

摘要

呼吸衰竭病患通常需藉由氣管內插管來接呼吸器使用，長期使用呼吸器患者，通常需將氣管內插管轉換成氣切造口。但是，作氣切的時間點至目前為止仍無明確的定論。此文章藉由實證醫學方式比較長期使用呼吸器患者，早期氣切及晚期氣切之效益。搜尋的資料庫有National Guideline Clearinghouse, The Cochrane Library, and PubMed。我們也搜尋了本土資料庫“華藝線上圖書館”（Airiti Library）。選中兩篇文章做嚴格評讀，一篇是出自The Cochrane Library的系統性回顧，一篇是本土世代研究文章，出自華藝線上圖書館。嚴格評讀結果顯示，早期氣切可減少呼吸器使用時間和住加護病房天數。

關鍵字

氣切 ； 長期使用呼吸器

並列摘要

Long-term mechanical ventilation is the most common situation where tracheostomy is indicated for patients in intensive care units. The ideal time for performing a tracheostomy has not been clearly established. We conducted this study to evaluate the effectiveness of early tracheostomy versus late tracheostomy in adult patient predicted to be on prolong ventilation. A fully recursive literature search was conducted in National Guideline Clearinghouse, The Cochrane Library, and PubMed. We also search local database: Airiti Library. Critical Appraisal Skills Programs were used to evaluate the quality of selected studies. We selected two articles which fulfilled our purpose. One is a system review from the Cochrane library and another is a local cohort study. After review, we found that early tracheostomy reduced the time spent on ventilatory support and in the intensive unit care.

並列關鍵字

Tracheostomy ； Long-term mechanical ventilation