Clinical Analysis of Different Types of Tracheal Cannulas Combined with Self-made Blockage Tubes for Postoperative Complications after Tracheotomy

doi:10.13701/j.cnki.kqyxyj.2024.01.007

Abstract

Abstract: Objective: To explore the clinical analysis of complications after gas resection in oral and maxillofacial patients using a combination of balloon cannula, metal tracheal cannula, and self-made blockage tube. Methods: The study subjects selected 100 patients who underwent oral and maxillofacial tracheostomy at the Affiliated Stomatological Hospital of Guizhou Medical University from June 2020 to August 2023, and conducted a retrospective analysis of their clinical data. The patients were randomly divided into a group with airbag cannula (47 cases) and a group with airbag cannula and metal cannula (53 cases). Both groups were combined with self-made cannulas. Clinical data, hospitalization time, clinical analysis, treatment methods, pathogenic bacteria of postoperative complications and pneumonia, and relevant factors for pneumonia after gas resection were analyzed. Results: After tracheotomy, the incidence of postoperative pneumonia was 36.00%. Compared with the airbag+metal group, the incidence rate of the airbag group was 2.12% (P<0.001), the incidence of bleeding was 1%, and subcutaneous emphysema was 1%. The airbag group did not experience tube detachment, while the incidence of tube detachment in the airbag+metal group was 20%. All patients did not experience breathing difficulties, difficulty in extubation, or tracheoesophageal fistula. In addition, the results of univariate analysis showed that patients with smoking history, and drinking history had a higher incidence of pneumonia after tracheotomy, which was statistically significant (P<0.05). Logistic regression analysis found that the duration of tracheal cannula removal and the type of tracheal cannula were comprehensive risk factors for pneumonia after gas resection (OR=0.021, 95%CI:0.002-0.19, P<0.001). Conclusion: After tracheotomy in oral and maxillofacial patients, the routine use of balloon cannula combined with self-made blockage tube can reduce patient hospitalization time, postoperative complications, and the occurrence of pneumonia.

Key words: tracheotomy, tracheal tube, pneumonia, self-restraint pipe plugging, complication

LI Shensui, TIAN Xudong, WANG Weili, TANG Zhenglong. Clinical Analysis of Different Types of Tracheal Cannulas Combined with Self-made Blockage Tubes for Postoperative Complications after Tracheotomy[J]. Journal of Oral Science Research, 2024, 40(1): 35-39.

References

[1] Goldenberg D, Ari EG, Golz A, et al. Tracheotomy complications:A retrospective study of 1130 cases [J]. Otolaryngol Head Neck Surg, 2000, 123(4): 495-500.
[2] Ong SK, Morton RP, Kolbe J, et al. Pulmonary complications following major head and neck surgery with tracheostomy: A prospective, randomized, controlled trial of prophylactic antibiotics [J]. Arch Otolaryngol Head Neck Surg, 2004, 130(9):1084-1087.
[3] Ardekian L, Barak M, Rachmiel A. Subcutaneous emphysema following emergent surgical conventional tracheostomy [J]. Craniomaxillofacial Trauma Reconstr, 2014, 7(4) :290-293.
[4] Riekert M, Rempel V, Keilwerth S, et al. Airway-associated complications with and without primary tracheotomy in oral squamous cell carcinoma surgery [J]. J Craniofac Surg, 2022, 34(1):279-283.
[5] 朱博文,庄海毛,秋怡,等.4种评分系统判断口腔癌患者术后气管切开需求的准确性评价[J].中国口腔颌面外科杂志,2022,20(2):129-134.
[6] 张叶,刘麒麟,常文娟,等.口腔颌面外科患者预防性气管切开堵管用具及方法的改良效果分析[J].吉林医学,2021,42(6):1510-1513.
[7] Morris L, Afifi MS. Tracheostomies: the complete guide [M]. NewYork: Springer Publishing Company, 2010:106-108.
[8] 中华人民共和国卫生部.肺炎诊断:WS382-2012 [S].北京,2012.
[9] Riekert M, Rempel V, Keilwerth S, et al. Airway-associated complications with and without primary tracheotomy in oral squamous cell carcinoma surgery [J]. J Craniofac Surg, 2023, 34(1):279-283.
[10] 蔡天怡,章文博,于尧,等.头颈部游离组织瓣移植术后预防性气管切开的临床分析[J].北京大学学报(医学版),2022,54(2):363-368.
[11] 刘芳芳,黄铄,方佳宇,等.气管切开术后不同类型气管套管的并发症及处理策略[J].武汉大学学报(医学版),2022,43(3):495-497.
[12] Leiser Y, Barak M, Ghantous Y, et al. Indications for elective tracheostomy in reconstructive surgery in patients with oral cancer [J]. J Craniofac Surg, 2017, 28(1): e18-e22.
[13] Mohamedbhai H, Ali S, Dimasi I, et al. TRACHY score: A simple and effective guide to management of the airway in head and neck cancer [J]. Br J Oral Maxillofac Surg, 2018, 56(8):709-714.
[14] Xu S, Wang K, Liu K, et al. Predictive nomogram for the necessity of tracheotomy during oral and oropharyngeal cancer surgery [J]. Laryngoscope, 2021, 131(5): E1489-E1495.
[15] Xu S, Liu S, Liu J. In response to predictive nomogram for the necessity of tracheotomy during oral and oropharyngeal cancer surgery [J]. Laryngoscope, 2021, 131(10): E2661.
[16] Abe A, Ito Y, Hayashi H, et al. The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery: A retrospective analysis [J]. Medicine (Baltimore), 2021, 100(30): e26712.
[17] Panuganti BA, Pang J, Francis DO, et al. Clinicodemographic predictors of tracheotomy tube size and decannulation: A multiinstitutional retrospective cohort study on tracheotomy [J]. Ann Surg, 2023, 277(5):e1138-e1142.
[18] Johansen NJ, Hahn CH. Prophylactic antibiotics at the time of tracheotomy lowers the incidence of pneumonia [J]. Dan Med J, 2015, 62(7): A5107.
[19] Reddy PD, Yan F, Nguyen SA, et al. Factors influencing the development of pneumonia in patients with head and neck cancer: A meta-analysis [J]. Otolaryngol Head Neck, 2021, 164(2):234-243.
[20] Li L, Yuan WJ, Zhang SL, et al. Analysis of risk factors for pneumonia in 482 patients undergoing oral cancer surgery with tracheotomy [J]. J Oral Maxillofac Surg, 2016, 74(2):415-419.
[21] Karthik K, Dhiwakar M. Predictors of surgical site infection and pneumonia following oral cavity tumor surgery [J]. Head Neck, 2021, 43(10):3106-3115.
[22] Chen XF, Chen YM, Gokavarapu S, et al. Free flap reconstruction for patients aged 85 years and over with head and neck cancer: clinical considerations for comprehensive care [J]. Br J Oral Maxillofac Surg, 2017, 55(8) :793 -797.