神经外科重症患者经皮扩张气管切开术后并发症的临床分析  

Clinical analysis of severe complications after percutaneous dilational tracheostomy in patients of Neuro-surgery Department

作　　者：徐跃峤[1] 程玮涛[1] 王宁[1] 陈文劲[1] 蒋丽丹[1] 

机构地区：[1]首都医科大学宣武医院神经外科,北京100053

出　　处：《中国综合临床》2016年第10期947-949,共3页Clinical Medicine of China

摘　　要：目的：分析神经外科重症患者经皮扩张气管切开（ PDT）后的并发症临床特点和救治方法，以为此类患者的治疗和抢救提供参考。方法回顾性分析首都医科大学宣武医院神经外科重症监护病房（ICU）2005－2015年进行PDT的病例578例，分析并发症种类、处置方法和预后。随访3月至1年。结果发生手术相关并发症的18例，并发症分别为出血、伤口感染、气管黏膜损伤造成窒息、气道内肉芽组织引起气道狭窄、皮下气肿、纵隔气肿等。经过对症处理和积极抢救，多数痊愈，无直接与手术相关死亡。结论 PDT在神经外科重症治疗中具有重要意义，损伤较小，但仍可能存在严重并发症，需要神经重症医师了解和重视，及时处理救治，减少不良预后。Objective To analyze the clinical characteristics and treatment Methods of severe com-plications after percutaneous tracheotomy（ PDT） in neurosurgery patients,and to provide reference for the treat-ment and rescue of these patients. Methods A retrospective analysis of 578 cases after PDT was performed in Neurosurgery Intensive Care Unit （ NSICU ） of Xuanwu Hospital of Capital Medical University from 2005 to 2015. The types of complications,treatment method and prognosis were analyzed. Follow-up was 3 months to 1 year. Results Eighteen cases with severe complications,including bleeding,wound infection,asphyxia caused by tracheal mucosa suffocation,airway stenosis caused by granulation tissue,subcutaneous emphysema and neu-momediastinum,etc. After treatment and active rescue,most patients recovered,no patients die directly associated with surgery. Conclusion PDT plays an important role in the treatment of patients in NSICU,but it is still pos-sible to have serious complications,so physicians must understand and be prepared for complications,and pay more attention to prevent poor prognosis.

关 键 词：经皮扩张气管切开 手术并发症 神经外科 气道管理 

分 类 号：R651[医药卫生—外科学]