The Effect of Early and Late Percutaneous Dilational Tracheostomy to Postoperative Infection Rate in Anterior Cervical Spine Surgery

Objective To explore the effect of early and late percutaneous dilational tracheostomy to postoperative infection rate in anterior cervical spine surgery.Methods From January 2011 to June 2012,a total of 52 patients received both anterior cervical spine surgery and tracheostomy at intensive care unit,patients were divided into early and late tracheostomy group,and their clinical data were collected.The period between postoperative cervical spine surgery and trachea cannula import: 3 d was defined as the early tracheostomy,≥3 d was defined as the late tracheostomy.The time of percutaneous dilational tracheostomy after anterior cervical spine surgery,length of mechanical ventilation time,length of ICU stay,occurrence of ventilator-associated pneumonia(VAP) and complication were compared between two groups.Results The time of percutaneous dilational tracheostomy after anterior cervical spine surgery,length of mechanical ventilation time and length of ICU stay in early tracheostomy group were shorter than those in late tracheostomy group respectively 〔(2 ± 1) d vs.(6 ± 1) d,(4 ± 2) d vs.(8 ± 3) d,(10 ± 5) d vs.(15 ± 4) d,P 0.05〕,and the occurrence of ventilator-associated pneumonia(VAP) in early tracheostomy group was lower than that of late tracheostomy group 〔55.0%(11 /20) vs.78.1%(25 /32),P 0.01〕.Slight bleeding from the tracheostoma was found in one patient of two groups respectively.Local tracheostoma infection was found in one patient in late tracheostomy group.No other complications,such as surgical fixation infection,were found among two groups.There was no difference in complication incidence 〔5.0%(1 /20) vs.6.2%(2 /32) 〕between the two groups(P 0.05).Conclusion Percutaneous dilational tracheostomy performed early after anterior cervical spine stabilization have more advantages than that of late and is very safe.