经皮穿刺牛角扩张微创气管造口术在ICU中的应用分析  

Application of minimally invasive tracheostomy with percutaneous horn expansion in ICU

作　　者：金晓玲[1] 包聿祥 周洁[1] 张要田[1] 

机构地区：[1]淮安市中医院ICU,江苏省淮安223001

出　　处：《中国基层医药》2017年第8期1182-1184,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 分析经皮穿刺牛角扩张微创气管造口术在ICU中的临床应用关键点,探讨微创手术遇到的问题及解决方法.方法 回顾性分析ICU中25例经皮穿刺牛角扩张微创气管造口患者的临床资料.结果 25例经皮穿刺牛角扩张微创气管造口ICU患者中,21例手术顺利完成（无切口溢痰、皮下气肿、气胸等并发症）,2例术后渗血较多,2例置管困难,其中有1例放弃置管,改为常规气管切开.结论 经皮穿刺牛角扩张微创气管造口术具有切口小,损伤少,手术时间短,出血量少,并发症发生率低等优点,但ICU患者病情重,易变化,要做好充分术前准备,掌控好手术中的关键步骤,寻找解决问题的对策.Objective To analyze the clinical key points of minimally invasive tracheostomy with percutaneous horn expansion applicated in ICU,and to discuss the problems encountered in minimally invasive surgery and the solutions.Methods The clinical data of 25 patients of minimally invasive tracheostomy with percutaneous horn expansion in ICU were analyzed retrospectively.Results Twenty-one patients with minimally invasive tracheostomy with percutaneous horn expansion were successfully performed in 25 patients of ICU （no incision sputum,subcutaneous emphysema,pneumothorax and other complications）,2 patients had more postoperative bleeding,2 patients were difficult to imbedding catheter,of which 1 case abandoned the catheter and received conventional tracheotomy.Conclusion Percutaneous horn expansion minimally invasive tracheostomy has the advantages of small incision,less injury,less operative time,less blood loss and low incidence of complications.However,ICU patients are in severe condition and easy to change.Adequate preoperative preparation,controlling the key steps in the operation can find a solution to the problme.

关 键 词：经皮穿刺牛角扩张气管造口术 ICU患者 微创手术 

分 类 号：R459.7[医药卫生—急诊医学]