改良经皮微创气管切开术在困难气管切开患者中的临床应用效果分析  

Clinical Application of Modified Percutaneous Minimally Invasive Tracheotomy in Patients with Difficult Tracheotomy

作　　者：李国胜 LI Guo-sheng(Department of Critical Care Medicine,Lingchuan County People's Hospital,Jincheng,Shanxi Province,048300 China)

机构地区：[1]陵川县人民医院重症医学科,山西晋城048300

出　　处：《系统医学》2019年第7期84-86,共3页Systems Medicine

摘　　要：目的探讨改良经皮微创气管切开术对于困难气管切开患者的影响。方法将该院2016年5月—2018年9月收治的74例困难气管切开患者以手术方式差别分为观察组(37例)和对照组(37例)2组,对照组患者给予常规气管切开术,观察组患者给予改良经皮微创气管切开术,观察2组患者的手术相关指标,并统计术中、术后并发症情况,以此评价切开术的优异性。结果观察组的手术用时为(11.20±3.62)min,短于对照组的(34.28±4.33)min(t=24.874 8、P=0.000 0);观察组术中出血量为(8.37±2.61)mL少于对照组(39.84±4.52)mL(t=36.675 3、P=0.000 0);观察组术后出血量为(2.51±1.03)mL,少于对照组(16.55±7.21)mL(t=11.725 9、P=0.000 0);观察组切口长度为(1.48±0.72)cm,少于对照组(3.48±1.41)mL(t=7.684 2、P=0.000 0);观察组愈合时间为(2.58±1.08)d,短于对照组(5.17±1.22)d(t=9.669 1、P=0.000 0);观察组出现心律失常为1例少于对照组的8例(χ~2=6.198 3、P=0.013 8);观察组低氧血症1例少于对照组的9例(χ~2=7.400 0、P=0.006 5);观察组皮下血肿例数0例少于对照组的4例(χ~2=4.228 6、P=0.039 7);差异有统计学意义,2组均未出现气管、食管漏。结论困难气管切开患者应用改良经皮微创气管切开术,不仅减少了术中、术后的出血量及手术用时,降低了并发症发生率。Objective To investigate the effect of modified percutaneous minimally invasive tracheotomy on patients with difficult tracheotomy. Methods 74 patients with difficult tracheotomy admitted to our hospital from May 2016 to September 2018 were divided into observation group(37 cases) and control group(37 cases). The patients in the control group were given conventional tracheotomy. The percutaneous minimally invasive tracheotomy was performed to observe the surgical related indexes of the two groups of patients, and the intraoperative and postoperative complications were evaluated to evaluate the superiority of the incision. Results The operation time of the observation group was(11.20±3.62) min shorter than that of the control group(34.28±4.33) min(t=24.874 8, P=0.000 0). The intraoperative blood loss was(8.37±2.61)mL in the observation group. The control group(39.84±4.52) mL(t=36.675 3, P=0.000 0);the postoperative blood loss in the observation group was(2.51±1.03) ml less than the control group(16.55±7.21)mL(t=11.725 9, P=0.000 0). The length of the incision in the observation group was(1.48 ±0.72) cm less than that in the control group(3.48±1.41)cm(t=7.684 2, P=0.000 0);the healing time of the observation group was(2.58±1.08)d shorter than the control group(5.17±1.22)d(t=9.669 1, P=0.000 0);1 case of arrhythmia in the observation group was less than8 cases in the control group, compared with(χ^2=6.198 3, P=0.013 8);1 case of hypoxemia in the observation group was less than the control group of 9 cases, the contrast(χ^2=7.400 0, P=0.006 5);the number of cases of subcutaneous hematoma in the observation group was less than that in the control group in 4 cases, compared with(χ^2=4.228 6, P=0.039 7),the difference was statistically significant;no tracheal or esophageal leakage occurred in the two groups. Conclusion Patients with difficult tracheotomy have improved percutaneous minimally invasive tracheotomy, which not only reduces the amount of bleeding during and after surgery, but also reduces the inc

关 键 词：困难气道 改良经皮微创气管切开术 应用效果 

分 类 号：R653[医药卫生—外科学]