微创经皮气管切开术在紧急气道中的应用  

Minimally invasive percutaneous tracheotomy was used in emergency airway

作　　者：赵保建[1] 王新河[1] 董迎春[1] ZHAO Bao-jian;WEANG Xin-he;DONG Ying-chun(Nanjing university medical college affiliated dental hospital(nanjing oral hospital),nanjing jiangsu 210008,China)

机构地区：[1]南京大学医学院附属口腔医院(南京市口腔医院),江苏南京210008

出　　处：《临床医药文献电子杂志》2017年第101期19803-19804,共2页Electronic Journal of Clinical Medical Literature

摘　　要：目的探讨采用微创经皮扩张气管切开术(Percutaneous dilatational tracheotomy,PDT)处理围手术期紧急气道的临床应用价值。方法选取我院2014年10月~2017年10月在南京市口腔医院因发生紧急气道而施行气管切开术的患者19例,其中11例采用微创经皮扩张气管切开术,8例行外科气管切开术surgical tracheotomy(ST)。对比两组病例的一般资料、气管切开时的血压、心率、切开时间、切口长度、出血量以及并发症等。结果两组病例一般资料比较,差异无统计学意义(P>0.05)。PDT组手术时间(4.2±1.8 min)和切口长度(1.4±0.4 cm)均显著短于ST组(分别为13.9±3.1 min,2.8±0.7 cm),差异有统计学意义(P<0.05),出血量(6.1±1.7 m L)明显少于ST组(17.5±4.8 m L),差异有统计学意义(P<0.05)。并发症发生率比较;差异无统计学意义(P>0.05)。结论 PDT可以更快地解决紧急气道,出血少,并发症少,适合用于围术期紧急气道管理。Objective To investigate the effect of minimally invasive preoperative percutaneous dilatational tracheotomy(PDT)in oral surgery anesthesia.Methods 19 patients undergoing preoperative percutaneous dilatational tracheotomy in Department of Anesthesiology,Nanjing Stomatological Hospital was conducted from October 2014 to October 2017.11 patients were treated with PDT while the other 8 patients were treated with traditional surgical tracheotomy(ST).The survey collected patient general information,anesthetics and surgical data,including vital signs,operation time,length of incision amount of bleeding and complications during the procedure.Results There is no significant difference in the general data between PDT group and ST group.Compared with ST group,the incision length and operation time are significantly shorter and the amount of bleeding is remarkably lower in PDT group(P<0.05).However,the incidence of complications between these two groups is not significantly different.Conclusion This study revealed that PDT could solve the emergent airway situation more rapidly with less bleeding and complications,and be very suitable for the management of emergency airway.

关 键 词：紧急气道 经皮扩张气管切开术 外科 

分 类 号：R65[医药卫生—外科学]