神经重症患者经皮气管切开与常规气管切开效果比较

 目的 探讨经皮气管切开术在神经重症患者中应用的临床价值。方法 回顾分析医院2015-01至2018-05收治并行气管切开的69例神经重症病例,按气管切开方式分为经皮扩张气管切开术(percutaneous dilatational tracheostomy,PDT,n=48) 组和常规气管切开(open surgical tracheostomy,ST,n=21)组,比较两组操作时间、血流动力学指标、颅内压(intracranial pressure,ICP)的波动及早期并发症的差异。结果 PDT组手术时间为(7.1±1.5)min,ST组为(13.5±4.9)min,ST组长于PDT组(P<0.05);ICP波动两组差别无统计学意义;血流动力学指标两组差别无临床意义。结论 PDT对神经重症患者的血流动力学及ICP影响较ST无明显差异,操作时间更短,可作为首选气管切开方法。

A comparison between percutaneous dilatational versus open surgical tracheostomy in neurocritical care patients

Objective To explore the clinical value of percutaneous tracheostomy in neuro critically ill patients. Methods The clinical data on 69 cases of neurocritical illness admitted to our hospital between January 2015 and May 2018 was retrospectively analyzed. According to treatments, these patients were divided into two groups: the PDT group (percutaneous dilatational tracheostomy, n=48) and ST group (open surgical tracheostomy, n=21). The clinical features, duration of surgery , bleeding volume, hemodynamics , intracranial pressure(ICP) and complications were compared between the two groups and statistically analyzed. Results There was significant difference in duration of surgery(7.1±1.5)min vs. (13.5±4.9)min]between the two groups, but there was no significant difference in intracranial pressure fluctuation or hemodynamic indexes. Conclusions There is no significant difference between ST and PDT in hemodynamics or intracranial pressure among neurocritical patients, but surgery takes less time with PDT. It should be the first option for neurocritical care patients.