纤维支气管镜引导经皮扩张气管切开术与开放式气管切开术在重症监护病房中的应用对比  

Comparison of the Application of Fiberbronchoscope-guided Percutaneous Dilated Tracheotomy and Open Tracheostomy in the Intensive Care Unit

作　　者：曾依龙 黄付杰 罗忠敏 刘炫 赵艳 ZENG Yilong;HUANG Fujie;LUO Zhongmin;LIU Xuan;ZHAO Yan(Bijie Hospital of Traditional Chinese Medicine,Bijie 551700,China;不详)

机构地区：[1]毕节市中医医院,贵州毕节551700

出　　处：《中外医学研究》2024年第3期21-24,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:比较开放式气管切开术与纤维支气管镜引导经皮扩张气管切开术在重症监护病房中的应用效果。方法:选择2021年12月—2023年3月于毕节市中医医院重症监护病房接受治疗的82例患者为研究对象,按照随机数表法将其分为研究组与常规组,各41例。研究组行纤维支气管镜引导经皮扩张气管切开术,常规组行开放式气管切开术。比较两组手术指标、生命体征指标[血氧饱和度(SpO_(2))、心率(HR)、平均动脉压(MAP)]水平,统计首次置管成功率,对比两组术后并发症发生情况。结果:研究组术中出血量少于常规组,手术时间短于常规组,颈部瘢痕长度短于常规组,差异有统计学意义(P<0.05)。置入气管套管时,两组HR、MAP水平均较气管切开前升高,SpO_(2)水平较气管切开前降低,但研究组SpO_(2)水平高于常规组,HR、MAP水平低于常规组,差异有统计学意义(P<0.05)。研究组首次置管成功率为92.68%,明显高于常规组的73.17%,差异有统计学意义(P<0.05)。研究组术后并发症发生率明显低于常规组,差异有统计学意义(P<0.05)。结论:重症监护病房患者采用纤维支气管镜引导经皮扩张气管切开术可改善手术指标,安全性较高,并能够提高首次置管成功率,术后并发症发生风险较低。Objective:To compare the application effects of open tracheostomy and fiberbronchoscope-guided percutaneous dilated tracheotomy in the Intensive Care Unit.Method:A total of 82 patients treated in the Intensive Care Unit of Bijie Hospital of Traditional Chinese Medicine from December 2021 to March 2023 were selected as the study objects,they were divided into study group and conventional group according to random number table method,with 41 patients in each group.Fiberbronchoscope-guided percutaneous dilated tracheotomy was performed in the study group,and open tracheostomy was performed in the conventional group.The levels of surgical indicators and vital signs[blood oxygen saturation(SpO_(2)),heart rate(HR),mean arterial pressure(MAP)]of the two groups were compared,the success rate of the first catheterization was calculated,and the incidence of postoperative complications was compared between the two groups.Result:The amount of intraoperative blood loss in the study group was less than that in the conventional group,the operation time was shorter than that in the conventional group,and the length of neck scar was shorter than that in the conventional group,the differences were statistically significant(P<0.05).When tracheotomy was implanted,HR and MAP levels in both groups were higher than those before tracheotomy,and SpO_(2)levels were lower than those before tracheotomy,however,SpO_(2)level in the study group was higher than that in the conventional group,while HR and MAP levels were lower than those in the conventional group,the differences were statistically significant(P<0.05).The success rate of the first catheterization in the study group was 92.68%,which was significantly higher than 73.17%in the conventional group,the difference was statistically significant(P<0.05).The incidence of postoperative complications in the study group was significantly lower than that in the conventional group,the difference was statistically significant(P<0.05).Conclusion:Fiberbronchoscope-guided percutaneous dilated trach

关 键 词：开放式气管切开术 纤维支气管镜 经皮扩张气管切开术 重症监护病房 并发症 

分 类 号：R653[医药卫生—外科学]