深静脉穿刺包在改良经皮扩张气管切开术中的效果评价  

Clinical effects and the costs of improved percutaneous dilatational tracheostomy with deep venous catheter package： a comparative study

作　　者：李建国[1] 马爱民[2] 张少华[2] 孟令宝[1] 郭志强[1] 

机构地区：[1]华北油田总医院加强医疗科ICU,河北任丘市062552 [2]华北油田总医院耳鼻喉头颈外科,河北任丘市062552

出　　处：《中国急救复苏与灾害医学杂志》2009年第5期317-319,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的观察深静脉穿刺包在改良经皮扩张气管切开术中的效果：方法将46例需要进行气管切开术的危重患者随机均分为观察组和对照组，观察组患者采用深静脉穿刺包和气管切开套管实施改良经皮扩张气管切开术，对照组采用常规经皮气管切开术经皮气管切开包实施手术。对比深静脉穿刺包在危重患者经皮气管切开术中应用的优势和不足：结果观察组的手术时间、术中及术后出血量分别为（15．22±1．75）nin．（10．49±2．17）ml．和（3．96±2．61）ml，与对照组相比[13．29±2．73）min．（9．76±2．48）ml，和（3．32±1．87）ml]差异无统计学意义（均P〉0．05）：而观察组费用为460元，显著低于对照组（3300元。P〈0．01）。结论深静脉穿刺包经皮气管切开术同样具有简单、快速，出血少的特点。同时现成包装且价格便宜，取材容易，在特殊情况下，如重大灾害发生时，可作为经皮气管切开包缺乏的替代品。Objective To study the clinical advantages of improved percutaneous dilatational tracheostomy （PDT） with deep venous catheter package. Methods 46 critically ill patients who required traeheostomy were randomly divided into 2 equal groups, observational group undergoing improved PDT with deep venous catheter package, and control group undergoing conventional PDT. The mean operational time, intra-operational blood loss, post-operational blood loss, and cost were compared between these 2 groups. Results No severe post-operational complications were seen in both groups. The operation time, intra-operational blood loss, and post-operational blood loss of the PDT group were （15.22±1.75） min, （10.49±2.17） ml, and （3.96± 2.61） ml respectively, all not significantly different from those of the eontrol group [（13.29±2.73） rain, （9.76±2.48） ml, and （3.32± 1.87） ml respeetively, all P〉0.05], but the cost of the PDT group was 460 yuan, significantly lower than that of the control group （3 300 yuan P〈 0.01）. Conelusion Improved PDT with deep venous catheter package and PDT package is as simple and rapid in procedure and with little blood loss as the conventional percutaneous traeheostomy. Percutaneous tracheostomy is a cost-effective alternative to standard open tracheostomy thanks to the ready-made and inexpensive deep venous catheter package. It can substitute for the conventional percutaneous tracheostomy in critical situation or disaster.

关 键 词：经皮扩张气管切开术 改良式 穿刺术 深静脉穿刺包 

分 类 号：R523[医药卫生—内科学]