改良式经皮气管切开术在严重烧伤治疗中的应用

目的寻求快速、微创、经济、实用气管切开方法,提高危重烧伤患者的抢救效率。方法将成人（18～68岁）烧伤面积大于30%或三度烧伤面积大于10%合并严重吸入性损伤患者116例,分为传统气管切开组和改良式经皮气管切开组,两组各58例,分别按传统气管切开方法和改良式经皮气管切开方法进行气管切开。结果改良式经皮气管切开组较传统气管切开组在愈合时间、出血量、手术时间、半年切口瘢痕面积分别减少5.6d、42.1ml、14min、2.85cm^2,切口感染、皮下气肿、气管内肉芽肿的发生率分别下降6.9%、15.52%、8.62%。结论改良式经皮气管切开方法操作时间短、损伤小、切口愈合快、疤痕轻,是严重烧伤合并吸入性损伤气管切开较好的术式之一。

Modified percutaneous tracheotomy in the treatment of severe burns

Objective To find a rapid, minimally invasive, economical and practical tracheotomy to improve quick rescue of severe burn patients.Methods One hundred and sixteen adults（18-68 years） with burns greater than 30%, or third-degree burns larger than 10% of the patients with severe inhalation injury were divided into two groups with 58 cases each.The two groups were given traditional tracheotomy and modified percutaneous tracheotomy respectively.Results Compared with the results in the former,healing time, blood loss,operative time, and incision scar area in the latter was reduced respectively by 5.6 d, 42.1 ml, 14 min, 2.85 cm^2.The incidence of wound infection, subcutaneous emphysema, and tracheal granuloma in the latter also dropped by 6.9%, 15.52%, and 8.62%.Conclusions The modified percutaneous tracheotomy, which takes shorter time and causes less injury, faster wound healing and milder scars, is a good surgery for severely burned patients with inhalation injury.