经皮微创气管切开术在重症监护病房中的应用  

Application of Percutaneous Dilational Tracheostomy in ICU

作　　者：李宏治[1] 申捷[1] 钟志越[1] 梁晓俊[1] 何岱昆[1] 

机构地区：[1]复旦大学附属金山医院ICU,上海200540

出　　处：《中国临床医学》2008年第3期332-334,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨经皮微创气管切开术(PDT)在重症监护室(ICU)危重患者人工气道建立中的应用价值。方法:69例患者行PDT,观察其手术时间、切口大小、术中出血量及各种并发症的发生率和手术死亡率等,并与传统的气管切开术进行比较。结果:PDT组的手术时间和手术切口长度均明显短于传统的气管切开术组(P<0.01),出血量明显少于传统组(P<0.01),两组皮下气肿和切口感染、套管脱出、肉芽和(或)瘢痕形成等并发症的发生率分别为0%、0%、0%、0%和15.00%、16.25%、11.25%、15.00%,两组比较均有显著差异(P<0.05)。而两组的手术死亡率则无显著差异(P>0.05)。结论:经皮微创气管切开术是一种微创的、快捷的急救技术,适合于ICU的危重患者,在ICU中有较大的应用价值。Objective：To explore the application value of percutaneous dilational tracheostomy（PDT） in ICU（intensive careunit） for patients who need to establish air way.Methods：Sixty-nine patients were tracheostomize with PDT and compared with traditional surgical tracheostomy,in terms of time for operation,cutting size,bleeding,occurrence of complication and mortality.Results：PDT when compared with the traditional surgical tracheostomy,the time for operation was shorter（P〈0.01）;the cutting size was smaller（P〈0.01）;the bleeding was less（P〈0.01）;the rates of skin emphysema,infection of incisional wound,fall out of the insertion tube,and scare formation were lower（0%,0%,0%,and 0% vs 15.00%,16.25%,11.25%,15.00%,respectively）.PDT was obviously better than traditional surgical tracheostomy.Conclusion：PDT is a kind of micro-surgery technique and very suitable for patients in ICU.

关 键 词：经皮气管切开术 人工气道 ICU 

分 类 号：R616[医药卫生—外科学]