Griggs yöntemi ile açılan 52 0lguda perkütan trakeostomi sonuçlarımız

Amaç: Yüzyıllardır uygulanan trakeostomi; yoğun bakım dalında ilerlemeler, değişen endikasyonlar, özellikle de yatak başı perkütan tekniklerin gelişmesiyle günümüzde daha da sık kullanılmaktadır. Perkütan trakeostominin hangi hastalarda, hangi yöntemle, ne zaman açılacağı tartışılmakta ve bu tekniğin hasta sonuçlarını nasıl değiştirdiği araştırılmaktadır. Perkütan trakeostominin sık kullanılan tekniklerinden biri olan Griggs tekniğini kullanarak açtığımız 52 perkütan trakeostomi olgusunu değerlendirdik. Gereç ve Yöntemler: Çalışmamızda, 2008-2010 yılları arasında Griggs tekniği ile perkütan trakeostomi açılan, yaşları 20-80 arasında değişen 18'i kadın, 34'ü erkek 52 olgu retrospektif olarak incelendi. Hemostatik bozukluğu olmayan, trakea ve boyun yapısı normal olan hastalara işlem uygulandı. Griggs tekniği ile perkütan trakeostomi için “Percutaneous tracheostomy kit (Portex)” kullanıldı. Olgularda işlem sırasında ve sonrasında gelişen komplikasyonlar kaydedildi. Bulgular: Tüm olgularda perkütan trakeostomi başarılı bir şekilde açıldı. Komplikasyon olarak 3 olguda (bir olguda cerrahi onarım gerektiren) kanama, 1 olguda subkutan amfizem, 1 olguda yara yeri infeksiyonu görülmüş olup, toplam komplikasyon oranı %9,6 olarak bulunmuştur. Hastaların geç dönem komplikasyonları değerlendirilmemiştir. İşlem sırasında pnömotoraks, ciddi hipoksi ve mortalite görülmemiştir. Sonuç: Griggs tekniği ile perkütan trakeostomi açılmasının yatak başında kısa sürede uygulanan, düşük komplikasyon oranına sahip bir yöntem olduğu kanaatine varıldı.

Percutaneous tracheostomy results of 52 cases which performed by GRIGGS method

Objective: Tracheostomy; which is performed for centuries is used more frequently by progression of intensive care province, changing indications and development of clinical techniques. It is a discussion that performing percutaneous tracheostomy to whom, in which method and when. It is also investigated that how that method changes results. We evaluated ‘'Griggs tecnique'' that is one of the most percutaneos tracheostomy techniques on 52 cases. Materials and Methods: In this study we investigated 52 patients. Percutaneous tracheostomy with Griggs method were performed to all patients. The study performed between 2008-2010. 18 female and 34 male patients were investigated. Patients ages were among 20-80. Normal tracheal and neck structurel Patients were selected for technique. There were also no hemostatic problem. ‘'Percutaneous tracheostomy kit (Portex)'' was used for percutaneous tracheostomy with Griggs method. Peroperative and postoperative complications were recorded. Results: Percutaneous tracheostomies were performed succesfully on all patients. Bleeding were seen on 3 patients (surgical treatment was required for one case), subcutaneous emphysema was seen on one patient and local infection was seen on tracheostomy area on one patient. Complication rate was 9.6 % totally. Long term complications were not evaluated. Pneumothorax, serious hypoxia and mortality were not seen during percutaneous tracheostomy operation. Conclusion: We conclude that percutaneous tracheostomy with Griggs technique is performed in a short time at the bedside and i has a low complication ratio.

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