气管切开手术后出血原因分析  

Causes of hemorrhage after tracheotomy

作　　者：朱运华[1] 王亮[2] 李梅生[1] 董明敏[2] 王险峰 

机构地区：[1]商丘市第一人民医院耳鼻咽喉科,河南商丘476100 [2]郑州大学第一附属医院耳科,河南郑州450052 [3]商丘市医学高等专科学校,河南商丘476100

出　　处：《中国耳鼻咽喉颅底外科杂志》2015年第3期208-210,共3页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：河南省科技厅课题(142102310522)

摘　　要：目的分析常规气管切开手术后并发出血的原因。方法回顾性分析2006年6月-2012年3月行气管切开术的536例患者,其中56例患者术后并发出血,按术后出血时间进行分组,分为术后24 h内出血和术后24 h后出血者,分析两组患者出血原因。对出血患者不同病因提出处理措施。结果气管切开术后2 w内并发出血的人数最多,发生率为46.43%,明显高于其他出血时间;术后24 h内的出血原因以凝血功能障碍（8.93%）为主,术后24 h后出血原因以套管、切口感染导致最多,分别占28.57%、35.71%,出血率最高,差异具有统计学意义（P〈0.05）。结论出血是气管切开术后最常见的并发症,引起术后出血的原因有很多,及时有效的处理可降低气管切开术后并发症。Objective To analyze the causes of hemorrhage after conventional tracheotomy. Methods Retrospective analysis was conducted on 536 patients with tracheotomy,who were admitted to our hospital between June2006 and June 2013,including 56 cases with postoperative hemorrhage. According to the bleeding time after operation,they were divided into group within 24 h and group after 24 h. The causes of the postoperative bleeding were analyzed by means of single factor analysis and logistic regression analysis. Treatment measures according to different causes of bleeding were put forward. Results Postoperative hemorrhage occurred most frequently within 2 weeks after tracheotomy,accounting for 46. 43%. The main cause of bleeding within 24 h was coagulation disorder（ 8. 93%）,while the causes of bleeding after 24 h were infection of sleeve and incision（ 28. 57%,35. 71%）. Conclusion Hemorrhage is the most common complication after tracheotomy due to a variety of possible causes. Timely and effective management is of benefit to reduce incidence of this complication.

关 键 词：气管切开术 出血 原因 处理对策 

分 类 号：R762[医药卫生—耳鼻咽喉科]