经皮穿刺气管切开术应用于急危重症患者的疗效

目的:观察经皮穿刺气管切开术应用于急危重症患者的疗效。方法:将2004年5月—2008年7月收治的112例需行气管切开术的急危重症患者分成2组,56例行经皮穿刺气管切开术治疗(研究组),56例行开放性气管切开术(对照组)。比较2组患者的手术时间、切口大小、术中出血量、拔管后切口愈合时间与并发症。结果:研究组手术时间(9.11±0.83)min,切口直径(1.06±0.25)cm,术中出血量(7.54±1.65)mL,拔管后切口愈合时间(4.27±0.44)d,并发症发生率14.28%(8/56);对照组手术时间(21.62±0.79)min,切口直径(3.25±0.31)cm,术中出血量(22.5±1.83)mL,拔管后切口愈合时间(7.62±0.65)d,并发症发生率21.43%(12/56);2组比较差异均有统计学意义(P0.01)。结论:经皮穿刺气管切开术具有简便、切口小、出血少、愈合快、并发症少等优点,适用于急危重症患者的抢救治疗。

Clinical Effect of Percutaneous Dilational Tracheostomy in Critically III Patients

Objective：To investigate the clinical effects of percutaneous dilational tracheostomy（PDT） in critically ill patients. Methods：A total of 112 critically ill patients who needed tracheotomy from May 2004 to July 2008 were divided into study group （56 patients undergoing PDT） and control group （56 patients undergoing open tracheostomy）. The operation time, incision length,bleeding volume,healing time of the tracheostomy and complications were compared between the two groups. Results： The operation time and the incision healing time in PDT group[（9.11 ±0.83）min and （4.27 ± 0.44）d] were significantly shor- ter than those in the control group[ （21.62 ± 0.79）min and （7.62±0.65）d], P〈 0.01. The incision length and the bleeding volume in PDT group[（1.06 ± 0.25）cm and （7.54 ±1.65）mL] were significantly less than those in the control group [（3.25 ± 0.31）era and （22.5 ± 1. 83）mL], P〈0.01. The complication rate in PDT group[14.28%（8/56）] was significantly lower than that in the control group[21.43% （12/56） ], P〈~0.0l. Conclusions： PDT has the advantages of simple performance, shorter incision, less bleeding, quicker incision healing,and less complications rate, compared with open tracheostomy.