自主研制的快速气管切开手术器械在急诊气管切开术中的应用  

Application of self-developed rapid tracheotomy apparatus for acute tracheotomy

作　　者：王翔玉 李集慧 鞠衍馨 刘震 马骏 孙铭钏 Wang Xiangyu;Li Jihui;Ju Yanxin;Liu Zhen;Ma Jun;Sun Mingchuan(Department of Anesthesia,Weihai Branch of The 970 Hospital of PLA Joint Logistics Support Force,Weihai 264200,Shandong Province,China;Department of Neurosurgery,Weihai Branch of The 970 Hospital of PLA Joint Logistics Support Force,Weihai 264200,Shandong Province,China;Department of Otolaryngology,Weihai Branch of The 970 Hospital of PLA Joint Logistics Support Force,Weihai 264200,Shandong Province,China)

机构地区：[1]解放军联勤保障部队第九七〇医院威海医疗区麻醉科,威海264200 [2]解放军联勤保障部队第九七〇医院威海医疗区神经外科,威海264200 [3]解放军联勤保障部队第九七〇医院威海医疗区耳鼻喉科,威海264200

出　　处：《中国基层医药》2023年第7期1056-1060,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨自主研制的快速气管切开手术器械行急诊气管切开术的应用效果。方法采用随机对照研究,选取解放军第九七〇医院威海院区2019年1月至2020年12月收治的需行急诊气管切开术的患者120例,采用随机数字表法将患者分为快速气管切开组60例(快速组)和传统气管切开组60例(传统组)。快速组采用自主研制的快速气管切开手术器械实施气管切开术,传统组按照传统开放性气管切开标准步骤进行操作。比较两组手术时间、切口长度、出血量及术后并发症发生情况。结果快速组手术时间为(4.5±0.9)min,显著短于传统组的(19.3±4.7)min(t=23.86,P < 0.001);切口长度为(2.8±0.3)cm,显著短于传统组的(4.2±1.3)cm(t=8.68,P < 0.001);术中出血量(4.4±1.6)mL,显著少于传统组的(11.8±4.1)mL(t=12.99,P < 0.001)。快速组手术并发症发生率显著低于传统组(χ^(2)=4.66,P=0.031)。结论自主研制的快速气管切开手术器械能快速、微创地建立人工气道,简化了操作步骤,明视下操作大大提高了安全性,降低了并发症发生率,而且可反复消毒、重复使用,具有显著的创新性,值得临床推广。Objective To investigate the application effects of self-developed rapid tracheotomy apparatus for acute tracheotomy.Methods A total of 120 patients who underwent an acute tracheotomy in the Weihai Branch of The 970 Hospital of PLA Joint Logistics Support Force from January 2019 to December 2020 were included in this study.These patients were randomly divided into a rapid group and a conventional group,with 60 patients in each group.Patients in the rapid group underwent tracheotomy with a self-developed rapid tracheotomy apparatus.Patients in the conventional group underwent the standard steps of traditional tracheostomy.The operation time,incision length,amount of bleeding,and incidence of postoperative complications were compared between the two groups.Results The operation time in the rapid group was significantly shorter than that in the conventional group[(4.5±0.9)minutes vs.(19.3±4.7)minutes,t=23.86,P<0.001].The length of incision in the rapid group was significantly shorter than that in the conventional group[(2.8±0.3)cm vs.(4.2±1.3)cm,t=8.68,P<0.001].The amount of bleeding during the surgery in the rapid group was significantly less than that in the conventional group[(4.4±1.6)mL vs.(11.8±4.1)mL,t=12.99,P<0.001].The incidence of postoperative complications in the rapid group was significantly lower than that in the conventional group(χ^(2)=4.66,P=0.031).Conclusion The self-developed rapid tracheotomy apparatus for acute tracheotomy can be used to establish an artificial airway quickly and minimally invasively by simplifying the operational steps.It is remarkably innovative to increase safety with open-view operations and decrease the incidence of complications.It can be repeatedly sterilized and reused,which is worthy of clinical application and popularization.

关 键 词：气管切开术 最小侵入性外科手术 外科器械 牵开器 扩张钳 人工气道 手术时间 手术后并发症 急诊处理 

分 类 号：R614[医药卫生—麻醉学]