牛角型经皮气管切开术在颅后窝及颅颈交界区术后患者的应用  

Application of horns percutaneous tracheostomy in the patients after posterior fossa and craniocervical junction surgery

作　　者：刘恒军[1] 闫传真 关靖宇[1] 

机构地区：[1]沈阳军区总医院神经外科,辽宁沈阳110016

出　　处：《现代仪器与医疗》2014年第4期37-39,共3页Modern Instruments & Medical Treatment

摘　　要：目的 :探讨牛角型经皮气管切开术在颅后窝及颅颈交界区术后患者的应用。方法:回顾性分析2013年1月到2013年11月重症神经外科26例颅后窝及颅颈交界区术后应用牛角型经皮气管切开术患者资料,对手术时间、安全性、并发症等进行分析总结。结果:26例行经皮气管切开术,手术时间除1例因局部解剖异常持续约15min,其余25例平均时间7.3±3.4min。平均术中出血量2.4±1.9mL。术后近期并发症术后出血1例;术后皮下气肿1例;无术后感染、套管脱落、痰痂形成阻塞套管、低氧血症及皮下血肿。感染、套管脱落、痰痂形成阻塞套管、低氧血症等术后远期并发症未发生。结论:牛角型经皮气管切开术具有出血少,时间短,安全性高特点,适用于颅后窝及颅颈交界区术后患者,解决了术后患者头部不能扭曲,不能过度屈伸,须轴线翻身但又需要气管切开的矛盾。Objective：To investigate the application of horns percutaneous tracheostomy in the patients after posterior fossa and craniocervical junction surgery.Methods：253 cases of tracheotomy patients were selected from the Department of Severe Neurosurgery between January 2013 and November 2013, and a retrospective analysis was performed on 26 cases of postoperative posterior fossa and craniocervical junction patients with horns percutaneous tracheostomy to analyze the operation time, safety and complications.Results：26 postoperative posterior fossa and craniocervical junction patients were treated with percutaneous tracheostomy, and the mean operation time of 25 patients was 7.3±3.4 minutes, except one patient with the operation time of 15 minutes due to the local anatomic abnormality. The mean intraoperative blood loss was 2.4±1.9 mL. The postoperative short-term complications： one cases of postoperative bleeding, no postoperative infection, no casing off, no formation of sputum that blocking casing, no postoperative hypoxemia; one case of postoperative subcutaneous emphysema, and no postoperative subcutaneous hematoma. Postoperative long-term complications： infection in 0 case; casing off in 0 case; sputum formation that blocking casing in 0 case and postoperative hypoxemia in 0 case.Conclusions：Horns percutaneous tracheostomy has the advantages of less bleeding, short time and high security, which is suitable for the patients with posterior fossa and craniocervical junction surgery, as it can help the patient that can not head distorted or excessive lfexion and extension, and can solve the contradiction in the patients that need axis turn but required tracheotomy.

关 键 词：经皮气管切开术 传统气管切开术 人工气道 颅颈交界区 颅后窝 

分 类 号：R651[医药卫生—外科学]