气管舌瓣造口改良气管切开术在困难气管切开患者中的应用  

Application of modified tracheoglossostomy in patients with difficult tracheotomy

作　　者：叶凡[1] 方潇碧[1] 夏志刚 吴聪 林刃舆[1] 李贺[1] YE Fan;FANG Xiaobi;XIA Zhigang;WU Cong;LIN Renyu;LI He(Department of Otolaryngology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;Department of Otolaryngology,Jiaxing Second Hospital,Jiaxing 314000,China)

机构地区：[1]温州医科大学附属第一医院耳鼻咽喉科,浙江温州325015 [2]嘉兴市第二医院耳鼻咽喉科,浙江嘉兴314000

出　　处：《温州医科大学学报》2024年第6期477-481,共5页Journal of Wenzhou Medical University

基　　金：温州市基础性科研项目(Y2020333)。

摘　　要：目的:探讨气管舌瓣造口改良气管切开术在困难气管切开患者中的应用价值。方法:选取2016年11月至2021年12月在温州医科大学附属第一医院接受气管切开术的困难气管切开患者42例进行回顾性分析,按气管切开方式不同分为暂时性气管切开术组(25例)和气管舌瓣造口改良气管切开术组(17例)。分析2组患者的术后首次换管时间、渗血量、术后并发症、决策时间和手术时间等指标。结果:与暂时性气管切开术组相比,气管舌瓣造口改良气管切开术组在术后首次换管时间、渗血量方面具有显著优势(P<0.05)。气管舌瓣造口改良气管切开术组较暂时性气管切开术组手术决策时间明显缩短(P<0.05);但两组手术时间差异无统计学意义(P>0.05)。气管舌瓣造口改良气管切开术组出现1例皮下气肿并发症,暂时性气管切开术组出现2例局部感染,3例意外脱管和1例气囊破裂。结论:气管舌瓣造口改良气管切开术相较暂时性常规气管切开术在术后并发症及结局方面有一定的优势。Objective:To study the application value of modified tracheotomy in patients with difficult tracheotomy.Methods:A retrospective study was conducted on 42 patients with difficult tracheotomy who underwent tracheotomy at the First Affiliated Hospital of Wenzhou Medical University between November 2016 and December 2021.They were divided into temporary tracheotomy group(25 cases)and modified tracheoglossostomy group(17 cases)according to different methods of gas incision.The first postoperative tube replacement time,blood volume,postoperative complications,decision time and operation time were analyzed.Results:Compared with the temporary tracheotomy group,the modified tracheoglossostomy group had significant advantages in the first postoperative tube replacement time and blood flow volume(P<0.05).Compared with the temporary tracheostomy group,the modified tracheoglossostomy group significantly shortened the surgical decision time(P<0.05).There was no significant difference in operation time between the two groups(P>0.05).There was 1 case of subcutaneous emphysema complications in the modified tracheoglossostomy group,and in the temporary tracheostomy group there were 2 local infections,3 accidental extubations and 1 balloon rupture.Conclusion:Modified tracheoglossostomy has certain advantages over temporary conventional tracheostomy in terms of postoperative complications and outcomes.

关 键 词：困难气管切开 气管舌瓣造口改良气管切开术 暂时气管切开术 

分 类 号：R762[医药卫生—耳鼻咽喉科]