Value of cervicothoracic CT combined with fiberoptic laryngoscopy in guiding decannulation in patients with tracheostomy after acquired brain injury
Objective To study the guiding value of cervicothoracic CT combined with fiberoptic laryn-goscopy for the successful decannulation in the patients with tracheostomy after acquired brain injury(ABI).Methods A retrospective analysis was adopted.Thirty-five rehabilitation patients with tracheostomy due to ABI in the First Affiliated Hospital of Anhui Medical University from January 2020 to May 2023 were selected as the study subjects.The patients all performed the cervical and thoracic CT combined with fiberoptic laryn-goscopic examination.The effects of upper airway patency,pulmonary infection and fibrolaryngoscopy evalua-tion indexes on the success of decannulation were analyzed.Results The success rate of decannulation was 68.57％.The subjects were divided into the decannulation group(n=24)and non-decannulation group(n=11)according to the decannulation situation.The tracheostomy time was 153(125,284)d in the decannulation group and 411(359,791)d in the non-decannulation group,and the difference between the two groups was sta-tistically significant(P＜0.05).The airway stenosis rate in the decannulation group was 20.83％(5/24),which in the non-decannulation group was 36.36％(4/11),and the difference was statistically significant(x2=8.26,P＜0.05).The incidence rate of recurrent infection in the decannulation group was 4.17(1/24),which in the non-decannulation group was 36.36％(4/11),and the difference was statistically significant(P＜0.05).The incidence rate of laryngeal edema in the decannulation group was 25.00％(6/24),which was lower than 36.36％in the non-decannulation group,the abnormal rate of vocal cord activity in the decannulation group was 12.50％(3/24),which was lower than 36.36％(4/11)in the non-decannulation group,and the difference was statistically significant(P＜0.05).Conclusion The airway stenosis,pulmonary infection,la-ryngeal edema and incidence rate of abnormal vocal cord activity have the guiding value in the successful de-cannulation of the patients with tracheostomy after ABI.
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