超声联合纤维支气管镜辅助在经皮扩张气管切开术中的应用价值分析  

Application value of ultrasound combined with fiberoptic bronchoscopy in percutaneous dilatation tracheotomy

作　　者：马福燕 张福帅 杜国然 赵树林 李涛[2] 朱娜 郭正通 霍莹 MA Fu-yan;ZHANG Fu-shuai;DU Guo-ran(Qingyun County People's Hospital,Dezhou 253700,China)

机构地区：[1]庆云县人民医院,253700 [2]中日友好医院,100029

出　　处：《中国实用医药》2024年第7期50-53,共4页China Practical Medicine

基　　金：国家高水平医院临床研究项目(项目编号:2022-NHLHCRF-LX-02-0124)。

摘　　要：目的分析超声联合纤维支气管镜辅助在经皮扩张气管切开术中的应用价值。方法回顾性分析220例实施经皮扩张气管切开术患者的临床资料,按照就诊时间顺序分为A组(单纯经皮扩张气管切开术治疗,108例)与B组(超声联合纤维支气管镜引导下经皮扩张气管切开术治疗,112例)。对比两组患者围术期指标(手术时间、术中出血量、切口长度、切口愈合时间、一次性置管成功率)及围术期并发症(切口感染、气管后壁破损、皮下气肿、其他)、远期并发症(声音嘶哑、咽喉异物感)发生情况。结果两组手术时间、切口长度、切口愈合时间对比,差异无统计学意义(P>0.05);B组术中出血量(6.5±2.2)ml少于A组的(10.4±3.1)ml,一次性置管成功率100.00%高于A组的94.44%,差异有统计学意义(P<0.05)。B组围术期并发症发生率相比A组较低,差异有统计学意义(P<0.05)。B组远期并发症发生率相比A组较低,差异有统计学意义(P<0.05)。结论超声联合纤维支气管镜辅助在经皮扩张气管切开术中应用可提高一次性置管率,且围术期及远期并发症发生率较低,安全性更高。Objective To analyze the application value ultrasound combined with fiberoptic bronchoscopy in percutaneous dilatation tracheotomy.Methods The clinical data of 220 patients undergoing percutaneous dilatation tracheotomy were retrospectively analyzed,and they were divided into group A(percutaneous dilatation tracheotomy,108 cases)and group B(percutaneous dilated tracheostomy under the guidance of ultrasound and fiberoptic bronchoscope,112 cases)according to the order of visit.Patients in both groups were compared in terms of perioperative indicators(operation time,intraoperative blood loss,incision length,incision healing time,success rate of one-time catheterization),perioperative complications(incision infection,posterior tracheal wall damage,subcutaneous emphysema,others),and long-term complications(hoarseness,foreign body sensation in throat).Results There was no significant difference in operation time,incision length and incision healing time between the two groups(P>0.05).The intraoperative blood loss of(6.5±2.2)ml in group B was less than(10.4±3.1)ml in group A,and the success rate of one-time catheterization of 100.00%was higher than 94.44%in group A.The difference was statistically significant(P<0.05).The incidence of perioperative complications in group B was lower than that in group A,and the difference was statistically significant(P<0.05).The incidence of long-term complications in group B was lower than that in group A,and the difference was statistically significant(P<0.05).Conclusion Percutaneous dilated tracheostomy under the guidance of ultrasound and fiberoptic bronchoscope can improve the rate of one-time catheterization,with low incidence of perioperative and long-term complications,and high safety.

关 键 词：超声 纤维支气管镜 经皮扩张气管切开术 并发症 

分 类 号：R653[医药卫生—外科学]