床旁纤维支气管镜引导经皮气管切开在ICU神经重症患者中的应用  

Application of bedside fiberoptic bronchoscope guided percutaneous tracheotomy in ICU patients with severe neurological diseases

作　　者：刘宁 邓石长 张志萍 Liu Ning;Deng Shichang;Zhang Zhiping(The People's Hospital of Yudu County,Yudu,Jiangxi 342300)

机构地区：[1]于都县人民医院,江西于都342300

出　　处：《基层医学论坛》2021年第26期3741-3743,共3页The Medical Forum

基　　金：赣州市指导性科技计划项目(GZ2020ZSF599)。

摘　　要：目的探讨对于重症监护室(ICU)神经重症患者采用床旁纤维支气管镜辅助下经皮气管切开的应用价值。方法将58例研究对象随机分成试验组(n=30)与对照组(n=28),对照组采取传统经皮气管切开方式,试验组应用床旁纤维支气管镜引导下经皮气管切开方式,对比2组干预情况。结果试验组患者在皮下气肿、气胸、纵隔气肿及气管后壁损伤等并发症的发生率上均明显低于对照组(P<0.05);试验组手术时间短于对照组,试验组术中出血量少于对照组,差异均有统计学意义(P<0.05)。结论对ICU重症患者应用经床旁纤维支气管镜引导的经皮气管切开效果满意,有助于降低并发症发生率,缩短手术时间及降低术中出血量。Objective To explore the application value of percutaneous tracheotomy assisted by bedside fiberoptic bronchoscope for critically ill patients in intensive care unit(ICU).Methods 58 cases were randomly divided into experimental group(n=30)and control group(n=28).The control group was treated with traditional percutaneous tracheotomy,while the experimental group was treated with bedside fiberoptic bronchoscope guided percutaneous tracheotomy.Results The incidence of subcutaneous emphysema,pneumothorax,mediastinal emphysema and tracheal posterior wall injury in experimental group were significantly lower than those in control group(P<0.05).The operative time in the experimental group was shorter than that in the control group,and the amount of intraoperative blood loss in the experimental group was less than that in the control group,with statistical significance(P<0.05).Conclusion For ICU patients with severe illness,the application of percutaneous tracheotomy guided by bedside fiberoptic bronchoscope has a satisfactory effect,which is helpful to reduce the incidence of complications,shorten the operation time and reduce the amount of intraoperative bleeding.

关 键 词：ICU 神经重症 经皮气管切开 床旁纤维支气管镜 一次性置管成功率 

分 类 号：R4[医药卫生—临床医学]