经皮旋转扩张气管切开术在危重病中的应用  

Application of a controlled rotating dilation percutaneous tracheostomy technique for patients with critical illness

作　　者：张国培[1] 邹其银[1] 向斌[1] 李海峰[1] 崔华永[1] 倪菊芳[1] 

机构地区：[1]东南大学医学院附属盐城医院,江苏盐城224001

出　　处：《临床医学》2009年第1期3-5,共3页Clinical Medicine

摘　　要：目的探讨经皮旋转扩张气管切开术在危重病中的应用价值。方法回顾性分析重症监护病房(ICU)中气管切开的危重病患者共88例,其中经皮扩张气管切开术组(PDT组)52例,常规外科气管切开术组(ST组)36例。比较两组手术操作时间、术中出血量、并发症发生率。结果PDT组手术操作时间为4～20 min,平均(8.6±2.8)min,ST组为13～28 min,平均(18.2±3.6)min,PDT组手术操作时间较ST组显著缩短(P<0.01);PDT组术中出血量<5 ml的48例,>5 ml的4例,ST组<5 ml的4例,>5 ml的32例,PDT组术中出血量较ST组显著减少(P<0.01);PDT组并发症发生率为3.8%,ST组为11.1%,PDT组并发症发生率较ST组明显减少(P<0.05)。结论经皮旋转扩张气管切开术是一种快速、术中出血量少、并发症少的微创气管切开术。除未成年人外,PDT可以广泛应用于ICU中的危重病患者。Objective To explore the application value of a controlled rotating dilation percutaneous tracheostomy technique in intensive care unit（ICU） for patients with critical illness. Methods The clinical data of 88 patients undergoing tracheotomy in ICU were analyzed retrospectively. Percutaneons dilational tracheostomy （PDT） was used in 52 patients, and in another 36 patients conventional surgical tracheostomy （ST） was used. The operation time, the intraoperative blood loss and the complications between the two groups were compared. Results The operation lasting time in group PDT[ 4 -20min, mean （8.6 ± 2.8 ）min ] was shorter than that in group ST[ 13 - 28 min, mean （ 18.2 ± 3.6） mini, P 〈 0.01. Bleeding less than 5 ml was found in 48 patients and that more than 5 ml was found in 4 patients in group PDT. The patients with bleeding less than 5 ml were 4 and more than 5 ml were 32 in group ST. The complication rate were 3.8% and 11.1% in group PDT and group ST respectively. In contrast with group ST, both the perioperative blood loss and complication rate were significantly reduced in group PDT （ P 〈 0. 01 and P 〈 0. 05 ）. Conclusion Percutaneous rotating dilation tracheostomy is a minimally invasive tracheostomy with fewer operation time, operative blood loss and complications. PDT should be used extensively in ICU in adults.

关 键 词：经皮旋转扩张气管切开术 外科气管切开术 危重病 

分 类 号：R459.7[医药卫生—急诊医学]