Tracheostomy n'oge ịbanye n'ime ndị ọrịa COVID-19

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Tracheostomy n'oge ịbanye n'ime ndị ọrịa COVID-19: nyocha maka omume ụlọ ọgwụ ugbu a

By Newsroom emelitere ikpeazụ Jul 17, 2020

Ndị ọrụ nlekọta ahụike rịọrọ arịrịọ ndị a na-atụghị anya ha, n'oge na-adịbeghị anya. Ọrịa ọrịa CroID-19 coronavirus gbanwere usoro omume. Ọrụ ọ bụla siri ike karịa na mbụ. Ndị na-eme nchọpụta na UK mere nnyocha na omume ụlọ ọgwụ ugbu a banyere nnabata tracheostomy n'oge ịbanye n'ime ndị ọrịa COVID-19.

Dị ka anyị niile maara, ọrịa COVID-19 na-ebute oria na-efe efe ma nwee ike ịga ngwa ngwa na nnukwu ọrịa okuku ume. [3] Ọtụtụ ọnọdụ ndị ọrịa, dịka ọrịa coronavirus dị mma, intubation na ikuku ikuku chọrọ mgbe niile. Ndị ọrịa ahụ chọrọ ikuku ga-adị ogologo oge, chọrọ tracheostomi iji nweta uru. [5] Uru gụnyere ịhapụ igbo na mposi mposi na ndị chọrọ ị inụ ikuku mgbe niile na ngalaba nlekọta ahụ. A na-ejikarị tracheostomy n'ime ndị ọrịa intubation n'etiti ụbọchị 7 na 10 na-esochi intubation. Agbanyeghị, ntuziaka ENT UK ghọtara mkpa ọ dị ịkpachapụ anya mgbe ha na-eme tracheostomy na ndị ọrịa COVID-19. [8] Ndị nchọpụta si mahadum dị na UK bipụtara nyocha ndị a iji chọpụta omume ụlọ ọgwụ.

Ahụmịhe na intagation ndị ọrịa COVID-19: ihe anyị nwere

Enwere ike ịmalite tracheostomy site na usoro ịwa ahụ na-emeghe ma ọ bụ nke na-agbanwe agbanwe, na-abụkarị n'akụkụ ihe ndina. Agbanyeghị, obere data na-egosi usoro dị mma na nsonaazụ na-esote na ndị ọrịa nwere ntụ oyi na COVID-7. Ókèala ndị China kacha nwee ọrịa na-efe efe mepụtara nghọta ka ukwuu banyere ụzọ kacha mma isi na-elekọta ndị ọrịa COVID-19. Ahụmahụ ha bara uru na ụlọ ọrụ ndị ọzọ tupu mmalite ọrịa. Ọ bụghị naanị n’ihe gbasara ịhazi ụzọ ndị ọrịa na akụrụngwa ahụike, kamakwa ịkọ ihe ga-esi na ya pụta. Ndị otu nyocha ahụ mere nnyocha nke mba iji chọpụta nnabata tracheostomy n'oge ịbanye n'ime COVID-19 ọrịa dị mma n'etiti ndị dọkịta nyocha ENT.

ENT dọkịta na-awa Ahụ: tracheostomy n'oge intubation na ndị ọrịa COVID-19: usoro na nsonaazụ

Nyocha a bụ Ọrụ Nrụpụta Ọrụ enwetara site na Nchọpụta na Ngalaba Mmepe nke'slọ Ọgwụ Mahadum NHS Foundation Trust, London. Ndị nchọpụta nyochara akwụkwọ nyocha dị n'ịntanetị nke gụnyere ajụjụ ndị a:

Kedu obodo / mpaghara i tibere?
Ole n'ime ndị COVID-19 nwere ndị ọrịa nọ n'ụlọ ọgwụ nwere onwe gị?
Kedụ pasent nke ndị ọrịa arara chọrọ ọrịa tracheostomy?
Ná nkezi, ụbọchị dị a wasaa ka tracheostomy mere (dịka, ụbọchị 7 nke intubation)?
Afọ ole ka ọrịa ahụ kwụsịrị onye na-ekuru ikuku?
Kedụ pasent ndị ọrịa nwụrụ n'agbanyeghị tracheostomy?
Nsonaazụ kachasị mma na usoro tracheostomy ọ bụla (wdg., Percutaneous vs ịwa ahụ)?

A kesara ajụjụ ahụ na March 27th, 2020 wee nabata data ruo Eprel 15th, 2020. Ndị ọrịa na ọha na eze etinyeghị aka na nrụpụta ma ọ bụ isiokwu a.

Emechara nyocha a site na ngụkọta ndị azịza iri ise sitere na United Kingdom (n = 50) na ndị mba ụwa (Onyinye 8) Ọnụ ọgụgụ ndị ọrịa ikuku dị 1 ebe ndị ọrịa 3403 nọ n'otu Ngalaba / ntụkwasị obi (nso 68-0). Onu ogugu ndi oria ji acho acho tracheostomy di 600% (oke 9.65% -0%) nke emere tracheostomi sochiri intubation na ubu ubochi 100 (onwa asaa rue asaa).

Emere ihe a site na ndị nzaghachi 28 sitere na 2701 nwere ndị ọrịa nọ na ikuku ma tụgharịa (ọgụgụ 2). Ọ dabara nke ọma, ndị ọrịa agbaghasịwo tracheostomy post nkezi mgbe ụbọchị 7.4 (ọnụọgụ 1-16 ụbọchị). N'agbanyeghị tracheostomy na nkezi 13.5% nke ndị ọrịa nwụrụ (na-adọta site na ndị na-aza 14 site na ọnụ ọgụgụ ndị ọrịa 1687 na-ekpuchi ma na-emegharị ahụ). N'ihe banyere usoro tracheostomy na nsonaazụ, mmadụ atọ n'ime mmadụ iri ise zaghachiri nyere tracheostomy dị mgbagwoju anya. Ndị nabatara mmadụ asatọ n'ime mmadụ iri ise nabatara ụzọ gwọọ oghe. Ndị zaghachirinụ ọzọ (3/50) kwuru na enweghị nke mmasị, ebe ndị ọzọ 8/50 enweghị ike itinye aka.

Kedu ihe nyocha a na tracheostomy n'oge ịbanye ọrịa na ndị ọrịa COVID-19 mere?

Data sitere na Wuhan na-egosi na etiti oge site na nnabata ụlọ ọgwụ ruo ọnwụ bụ ụbọchị 5 n'ime ọnwa mbụ nke ọrịa na-efe efe, nke pụtara ụbọchị 11.[14] Ọrịa COVID-19 ebutela ọchịchọ na-enweghị atụ maka ọrụ nlekọta dị oke mkpa yana mkpa nke intubation na ikuku ikuku.[1] Ndị na-aghọ nke siri ike chọrọ intubation na igwe ikuku ikuku dị elu n'ihi na ọ na-aga n'ihu ngwa ngwa nke oyi baa. Ọ na-atụgharị ghọọ nnukwu nnukwu iku ume ọrịa na-ebute ọdịda iku ume na ọnwụ.[3,12,13].

Ndụmọdụ ndị dị ugbu a bipụtara na Mahadum American nke Otorhinolaryngology-Head na olu Wa ahụ na-atụ aro ka ekwesighi ịme tracheostomy tupu ụbọchị 14 nke ịmịnye. [15] Nsonaazụ nke nyocha a ga-atụ aro na ihe dị ka 1 onye n'ime mmadụ 10 ọ bụla na-arịa ọrịa COVID-19 ma na-eme ka ikuku na-achọ tracheostomy. Nsonaazụ ndị ọzọ ga-atụ aro na ngalaba na-agbaso usoro iwu yiri nke a na-eme obere tracheostomy mgbe niile.

Agbanyeghị, anyị kwesịrị ịma nsogbu ọghọm nke ikuku nwere ike ịnọ ogologo oge na ndị nke a ga-ahapụrị ịhapụ ịnara. Ndị a gụnyere ọrịa afọ mgbu azụ, stenosis na ọrịa fioula tracheo-esophageal. [5] Ọrịa nlekọta akụrụngwa ọ bụrụ na ọ ga -ekwesịrị iburu ebe nile. [16]

Ọrịa ga-achọkwu ikuku ga-adị ogologo. Nke a ga - akpata atrophy muscular nke nwere ike ogologo ma ọ bụ gbochie ya ịhapụ ya. [17] Nkwupụta nke mgbawaze na ọnya ume ọkụ na ọnya nwere ike machibidoro mkpochapụ ma mee ka ọ dịkwuo mkpa maka ịbanye mmiri, ịsa ahụ na ikuku. Enwere ike merie nke a site na tracheostomy.

Agbanyeghị, nyocha a egbochighi uru doro anya ọ bụla gbasara usoro tracheostomy. Nkwupụta nke ndị zaghachiri kọwara na ejiri ihe metụtara ọnọdụ n'okwu ikpe dabere na ahụmịhe mpaghara. Mkpesa gụnyere ọnụ ọgụgụ ndị zaghachirinụ nwere ezigbo ndị ọrịa COVID-19 tinyechara ọnụ ọgụgụ ndị akọwapụtara. Ndị ode akwụkwọ a gosipụtara ekele dị ukwuu ha nwere maka ndị wepụtara oge iji zaghachi nyocha a iji kwado mkpebi ndị ọrụ ibe nọ n'akụkụ ụwa niile.

NDỊ aka

Ayman D'Souza: Christ Church, Mahadum nke Oxford, Oxford, UK

Ricard Simo FRCS (ORL-HNS): Ngalaba Otorhinolaryngology, Guy's na St Thomas 'NHS Foundation Trust, London, UK

Alwyn D'Souza FRCS (ORL-HNS): Ngalaba Otorhinolaryngology, Hospitallọ Ọgwụ Mahadum Lewisham, London, UK

Francis Vaz FRCS (ORL-HNS): Ngalaba nke Isi na Surwa Ahụ, University College Hospital, London, UK | Institute of Medical Science, Medway Campus, Canterbury Christ Church University, Kent, UK

Andrew tupu FRCS (ORL-HNS): Ngalaba Otorhinolaryngology, Princess Royal University Hospital, Kent, UK

Rahul Kanegaonkar FRCS (ORL-HNS): Institute of Sciences Medical, Medway Campus, Canterbury Christ Church University, Kent, UK

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