经皮气管切开与传统气管切开在重症患者中的应用  

Application of percutaneous tracheotomy and traditional tracheotomy in critically ill patients

作　　者：严银宗 YAN Yinzong(Department of Neurology,People′s Hospital of Yunfu City,Guangdong Province,Yunfu 527300,China)

机构地区：[1]广东省云浮市人民医院神经内科,广东云浮527300

出　　处：《中国当代医药》2022年第7期39-41,45,共4页China Modern Medicine

基　　金：广东省云浮市医学科学技术研究项目(2020B011)。

摘　　要：目的比较经皮气管切开术与传统气管切开术在重症患者中的应用效果。方法选取2020年6月至2021年8月广东省云浮市人民医院接受气管切开治疗的60例重症患者作为研究对象,按照随机数字表法将所有患者分为治疗组和对照组,每组30例。对照组采用传统气管切开术治疗,治疗组采用经皮气管切开术治疗,记录并比较两组患者在不同治疗方式下的术口直径、术中出血量、手术时间、拔管后术口愈合时间等围手术期各项指标,统计两组患者经不同方式治疗后的并发症总发生率及死亡率。结果两组患者的术口直径、手术时间比较,差异无统计学意义(P>0.05);治疗组的术中出血量少于对照组,拔管后术后愈合时间短于对照组,术后相关并发症总发生率为10.00%(3/30),低于对照组的23.33%(7/30),死亡率为3.33%(1/30),低于对照组的13.33%(4/30),差异有统计学意义(P<0.05)。结论相较于传统气管切开术而言,采用经皮气管切开术可有效减少患者术中出血量,经皮气管切开术可实现拔管后术口快速愈合,且在此术式下患者不易出现相关并发症,其死亡率更低,预后情况更佳,经皮气管切开具有更高的临床应用价值。Objective To compare the application effect of percutaneous tracheotomy and traditional tracheotomy in critically ill patients.Methods A total of 60 critically ill patients who underwent tracheostomy treatment at People′s Hospital of Yunfu City from June 2020 to August 2021 were selected as the research objects.According to random number table method,they were divided into treatment group and control group,with 30 cases in each group.The control group was treated with traditional tracheotomy,and the treatment group was treated with percutaneous tracheotomy.The diameter of the surgical incision,intraoperative blood loss,operative time and extubation of the two groups were recorded and compared.Perioperative indicators such as the healing time of the posterior surgical incision,the incidence of complications and mortality of the two groups of patients after different treatments were counted.Results There were no statistically significant differences in the surgical incision diameter and operation time between the two groups(P>0.05).The intraoperative blood loss of the treatment group was less than that of the control group,and the postoperative healing time after extubation was shorter than that of the control group,the total complication rate was 10.00%(3/30),lower than 23.33%(7/30)of the control group,the mortality rate was 3.33%(1/30),lower than 13.33%(4/30)of the control group,the differences were statistically significant(P<0.05).Conclusion Compared with traditional tracheotomy,the use of percutaneous tracheotomy can effectively reduce the amount of intraoperative blood loss in patients.Percutaneous tracheotomy can achieve rapid healing of the surgical incision after extubation,and under this operation,patients are not likely to have related complications,the mortality rate is lower,and the prognosis is better.Percutaneous tracheotomy has higher clinical application value.

关 键 词：经皮气管切开 传统气管切开 疗效比较 预后分析 

分 类 号：R653[医药卫生—外科学]