经皮扩张气管切开术在ICU的临床观察

目的为ICU危重症患者寻找一种微创、简便、快速的气管切开方法,从而提高抢救的成功率。方法将80例需要气管切开的患者分为两组,分别进行经皮扩张气管切开术(percutaneous dilational tracheostomy,PDT)和传统的开放性气管切开术(surgical tracheostomy,ST),对比两组患者手术时间、切口大小以及手术并发症等情况。结果 PDT组手术时间(8.5±4.2)min、切口长度(1.4±0.2)cm、出血量(5.4±1.6)mL、切口愈合时间(6.5±1.2)d、瘢痕面积(0.4±0.23)cm2与ST组的手术时间(23.4±9.1)min、切口长度(4.5±0.3)cm、出血量(17.1±3.1)mL、切口愈合时间(9.5±2.1)d、瘢痕面积(0.8±0.37)cm2比较,差异均有统计学意义(均P<0.05);手术并发症发生率PDT组(5%)明显小于ST组(30%),P<0.05。结论经皮扩张气管切开术是一种微创的外科气管切开术,对于ICU危重症患者人工气道的建立有很高的应用价值。

The Application Research of Percutaneous Dilational Tracheostomy in ICU

Objective To search for a new simple,rapid,minimally invasive tracheostomy for patients in ICU for improving the success rate of rescue.Method 80 patients who need tracheostomy were randomly divided into percutaneous dilational tracheostomy(PDT)group and surgical tracheostomy(ST) group.The operation time,incision size and complications between two groups were compared.Results In PDT group,operative time was 8.5±4.2 min,the incision length(1.4±0.2)cm,the amount of bleeding(5.4±1.6)mL,wound healing time was(6.5±1.2)d,the scar area(0.4±0.23)cm2 and in ST group it was(23.4±9.1)min,(4.5±0.3)cm,(17.1±3.1)mL,(9.5±2.1)d,(0.8±0.37)cm2(P<0.05),respectively;in PDT group surgical complication rate was 5% while it was 30% in ST group(P<0.05).Conclusion Percutaneous dilational tracheostomy is a minimally invasive surgical operation which has a high value for the critical care patients in ICU with artificial airway.