床旁纤维支气管镜辅助下经皮穿刺气管切开术在ICU中的应用分析  

Applicable Analysis of Percutaneous Tracheotomy Assisted by Bedside Fiberoptic Bronchoscope in ICU Patients

作　　者：洪春巧 张懋 李天林 HONG Chunqiao;ZHANG Mao;LI Tianlin(Xiamen Chang Gung Hospital Hua Qiao University,Xiamen 361028,China)

机构地区：[1]华侨大学附属厦门长庚医院,福建厦门361028

出　　处：《中外医学研究》2023年第32期22-27,共6页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：厦门市科技局项目(3502Z20227375)。

摘　　要：目的:探讨床旁纤维支气管镜辅助下经皮穿刺气管切开术在重症监护病房(ICU)中的应用价值及优势。方法:回顾性分析2018年1月─2022年12月华侨大学附属厦门长庚医院ICU收治的行气管切开术的90例患者的临床资料,根据手术实施方式将其分为传统外科方式气管切开术组(A组)30例、床旁经皮穿刺气管切开术组(B组)30例、床旁纤维支气管镜辅助下经皮穿刺气管切开术组(C组)30例。比较三组手术切口大小、手术时间、术中出血量、并发症发生情况、术后住ICU时间等指标。结果:A组所有患者均进行手术切口缝合,占比为100.00%;B组有8例患者进行手术切口缝合,占比为26.67%;C组患者中仅有3例进行手术切口缝合,占比为10.00%,三组比较,差异有统计学意义(P<0.05);三组术中出血量、手术切口大小、手术时间比较,差异有统计学意义(P<0.05);A组术中出血量显著多于B组和C组,手术切口大小、手术时间显著长于B组和C组,B组术中出血量显著多于C组,手术切口大小、手术时间显著长于C组,差异有统计学意义(P<0.05)。三组并发症总发生率比较,差异有统计学意义(P<0.05)。A组费用最高,C组次之,B组费用最低。三组气管切开术后住ICU天数比较,差异无统计学意义(P>0.05)。结论:床旁纤维支气管镜辅助下经皮穿刺气管切开术具有安全、便捷、视野清晰、切口小、手术时间短、并发症少等优点。Objective:To investigate the application value and advantages of percutaneous tracheotomy assisted by bedside fiberoptic bronchoscope in intensive care unit(ICU).Method:The clinical data of 90 patients undergoing tracheotomy admitted to the ICU of Xiamen Chang Gung Hospital Hua Qiao University from January 2018 to December 2022 were retrospectively analyzed.According to the operation method,the patients were divided into traditional surgical tracheotomy group(group A)in 30 cases,bedside percutaneous tracheotomy group(group B)in 30 cases,and bedside fiberbronchoscope-assisted percutaneous tracheotomy group(group C)in 30 cases.The incision size,operation time,intraoperative blood loss,complications and postoperative ICU stay were compared among the three groups.Result:All patients in group A underwent surgical incision suture,accounting for 100.00%;in group B,8 patients underwent surgical incision suture,accounting for 26.67%;in group C,only 3 patients underwent surgical incision suture,accounting for 10.00%,and the difference among the three groups was statistically significant(P<0.05).There were significant differences in intraoperative blood loss,incision size and operation time among the three groups(P<0.05).The amount of intraoperative blood loss in group A was significantly higher than that in group B and group C,the size and time of surgical incision were significantly longer than those in group B and group C,and the amount of intraoperative blood loss in group B was significantly higher than that in group C,and the size and time of surgical incision were significantly longer than that in group C,the differences were statistically significant(P<0.05).There was significant difference in the total incidence of complications among the three groups(P<0.05).Group A had the highest cost,followed by group C,and group B had the lowest.There was no significant difference in the days of ICU stay among the three groups after tracheotomy(P>0.05).Conclusion:The bedside fiberoptic bronchoscopy assisted percutaneous trache

关 键 词：经皮穿刺气管切开术 纤维支气管镜 重症监护病房 

分 类 号：R459.7[医药卫生—急诊医学]