B超引导下经皮气管切开105例临床分析  

Clinical analysis of percutaneous dilational tracheostomy guided by B ultrasound

作　　者：柏正群[1] 吴丽芳[2] 纪周群[3] 姜建军[4] 刘建兵[1] 

机构地区：[1]江苏省盐城市大丰人民医院耳鼻咽喉头颈外科,大丰224100 [2]江苏省盐城市大丰人民医院重症监护室,大丰224100 [3]江苏大学附属江滨医院耳鼻咽喉头颈外科,镇江212013 [4]江苏省盐城市大丰人民医院超声科,大丰224100

出　　处：《中国眼耳鼻喉科杂志》2017年第3期202-203,共2页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨B超引导下经皮气管切开术在急危重症患者人工气道建立中的临床效果。方法对105例气管定位困难的患者,术前在B超引导下,82例患者选择第2~3气管环间隙为穿刺点,23例患者从第1~2气管环间隙穿刺,然后行正规经皮气管切开术,观察术中出血量、手术时间及术后并发症。结果术前超声结果显示,6例患者甲状腺峡部缺如,气管位置能清晰定位。105例患者均一次手术成功。手术中出血量为5~8 mL,手术时间为6~15 min。手术过程顺利,术中未发生气管严重损伤、大出血等并发症。术后切口出血6例,感染3例。结论 B超引导下经皮气管切开术适合于急危重症患者人工气道建立,具有穿刺定位准确、安全、微创、出血少、术后并发症少等优点。Objective To investigate the clinical value of the percutaneous dilatational tracheostomy （PDT） guided by B ultrasound in critically ill patients. Methods Data of 105 cases with tracheotomy difficulty in locating the trachea were analyzed retrospectively. All cases were treated with percutaneous dilatational tracheostomy guided by B ultrasound. The operation time, blood loss and postoperative complications were observed. Results The results of preoperative ultrasound showed that there were no thyroid isthmus in 6 cases , and the position of trachea could be clearly located. One hundred and five patients had obtained satisfied clinical value after PDT guided by B ultrasound. The operation lasted for 6 - 15 minutes. No serious complications such as serious injury or hemorrhage occurred during the operation. Conclusions PDT guided by B ultrasound is a safe, effective, and simple method with less perioperative complications for critically ill patients. （Chin J Ophthalmol and Otorhinolaryngo1,2017 ,17 ：202-203 ）

关 键 词：超声检查 气管切开术 经皮扩张气管切开术 

分 类 号：R459.7[医药卫生—急诊医学]