经皮气管切开术与传统气管切开术在神经重症患者救治中安全性的多中心随机对照研究  

Multicenter randomized controlled study of percutaneous tracheostomy and conventional tracheostomy patients in neurological intensive treatment

作　　者：陈通[1] 付爱军[1] 朱军[1] 李建民[1] 肖增兵 宋向奇 何玉新[2] 李素花[2] 孙超 姜蕊 王瑞刚[4] 

机构地区：[1]河北联合大学附属医院神经外科,河北省唐山市063000 [2]河北联合大学附属医院曹妃甸区医院 [3]唐山市古冶区中医院 [4]河北联合大学附属医院神经重症医学科,河北省唐山市063000

出　　处：《中国综合临床》2014年第6期581-584,共4页Clinical Medicine of China

基　　金：唐山市科学技术研究与发展计划课题（08130204A-1-12）

摘　　要：目的：探讨经皮气管切开术（PDT）与传统气管切开术在神经重症患者救治中的安全性评价。方法本研究设计为多中心、前瞻性、随机对照的临床试验方法，共纳入了2010年2月至2013年2月在3家医院住院的176例气管切开的急性神经重症患者，随机分为传统气管切开组和经皮气管切开组，记录手术操作时间及观察气胸、皮下气肿、气管瘘、食管损伤、气管脱出以及肺部感染等并发症的发生率。结果传统手术组并发症发生率[19.51％（16/82）]明显高于经皮气管切开组[8.51％（8/94）]（P =0.021），经皮气管切开术在手术时间上明显优于传统气管切开术[（7.5±2.3）、（41.6±5.8）min，P=0.000]。结论经皮气管切开术能有效快速建立神经重症患者的气道，操作简便、安全，降低呼吸系统并发症的发生率。Objective To explore safety evaluation of the approaches of the percutaneous eilational tracheostomy（PDT）ane traeitional tracheotomy in the treatment of neurological patients. Methods The stuey eesign was a multicenter,prospective,raneomizee clinical trial. One huneree ane seventy-six cases with acute nerve trachea incision from Feb. 2010 to Feb. 2013 of 3 hospitals were selectee as our subject. They were raneomly eivieee into the traeitional group ane PDT group. The information inclueing operation time,the incieence of pneumothorax,subcutaneous emphysema,tracheal fistula,esophageal,trachea ane lung injury from complications such as infection were recoreee. Results The complication rate in traeitional group was 19. 51%（16 / 82）,higher than that of PDT group（8. 51%（8 / 94）,P = 0. 021）. The surgery perioe in PDT group was（7. 5 ± 2. 3）min,shortee than that in traeitional group（（41. 6 ± 5. 8）min,P = 0. 000）. Conclusion The approach of percutaneous tracheostomy can quickly buile airway of neurological patients with character of simple, safe,ane it also can reeuce the incieence of respiratory complications.

关 键 词：神经重症 经皮气管切开 传统气管切开术 

分 类 号：R459.7[医药卫生—急诊医学]