经皮旋转扩张气管切开术安全性的大宗病例研究  

The safety study of percutaneous dilational tracheostomy in a large sample

作　　者：翟翔[1] 张金玲[1] 何京川[1] 刘钢[1] 

机构地区：[1]天津市环湖医院耳鼻咽喉科,天津300350

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第3期176-178,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:通过分析大宗病例研究经皮旋转扩张气管切开术(PDT)的安全性。方法:回顾性分析1 200例行PDT和326例行传统的气管切开术(TT)患者的临床资料,统计分析术后并发症情况。进行PDT和TT两组随机对照试验,每组80例,统计手术中情况(包括手术时间、术中出血量和切口大小)以及术后并发症情况,采用SPSS 17.0软件进行数据分析。结果:(1)随机对照研究:2组患者术中出血量、切口大小和手术时间比较差异均有统计学意义;术后出血例数和并发症总数比较差异均有统计学意义(均P<0.05),肉芽形成、切口感染和皮下气肿比较差异均无统计学意义(P>0.05)。(2)大样本研究:术后出血、术后感染、皮下气肿及并发症总数差异均有统计学意义(均P<0.05),气管内肉芽形成无明显差异(P>0.05)。结论:本研究通过大样本和随机对照研究进一步验证PDT是一种快速建立长久人工气道的安全方法,符合现代微创的手术发展方向。PDT不仅手术操作时间短,技术易于掌握,而且安全可靠。对于需行气管切开术的危重症患者,如无明显手术禁忌证,可以首先选择PDT,在熟练掌握了其操作技巧后,成功率和安全性都很高。Objective：The aim of this study is to analyze the safety of a large number cases of percutaneous dilatation tracheostomy.Method：Retrospective analyzed the clinical data of PDT（1 200 cases）and TT（326 cases）patients which were recruited.The postoperative complications were analyzed statistically.PDT and TT randomized controlled trials（PDT and TT）were conducted with 80 cases in each group.The intraoperative conditions（including operative time,intraoperative bleeding volume and incision size）and postoperative complications in the two groups were statistically analyzed.The data were analyzed by SPSS 17.0 software.Result：（1）Randomized controlled study：The blood loss,incision size and operative time of two groups have significant difference.Comparison of postoperative complications：the number of postoperative bleeding and the total number of complications were statistically significant difference（P〈0.05）.However,granulation formation,incision infection and subcutaneous emphysema showed no significant difference（P〈0.05）.（2）Large sample study：The postoperative follow-up results showed that there were significant differences in postoperative bleeding,postoperative infection,subcutaneous emphysema and the total number of complications（P〈0.05）,but there was no significant difference in the formation of tracheal granulation（P〈0.05）.Conclusion：This study further validates that PDT is a safe method to establish long-term artificial airway through large sample and randomized controlled study,which accords with the direction of modern minimally invasive surgery.PDT not only short operation time,and is easy to grasp,but also safe and reliable.If there is no obvious operation contraindication,we can choose PDT first for critically ill patients who need tracheotomy,and the success rate and safety are high after mastering the operation skills.

关 键 词：气管切开术 微创 并发症 

分 类 号：R653[医药卫生—外科学]