气管切开术并发症的原因及预防处理措施

目的探讨气管切开术并发症发生的原因及预防处理措施。方法对116例患者（颅脑外伤68例，口腔颌面部骨折3例，闭合性喉气管外伤10例，高血压脑出血行颅内血肿清除术后15例，高血压脑出血昏迷未行开颅手术患者3例，头面颈部烧伤引起上呼吸道水肿2例，喉梗阻5例）进行常规气管切开术，分析并发症的发生原因，探讨气管切开术并发症的预防处理措施。结果116例患者中共有10例出现相关并发症，并发症发生率为8．62％，其中呼吸、心脏骤停2例（1．72％），皮下气肿3例（2．59％），出血2例（1．72％），气管套管脱出2例（1．72％），气管食管瘘1例（0．86％）。结论把握手术时机，完善术前准备，术中仔细确认颈部解剖标志，熟练的技巧，严密的配合，加强术后护理，可有效减少气管切开术并发症的发生。

The causes and management of complications of tracheotomy

Objective To explore the possible causes of complications of tracheotomy and ways of treatment. Methods 116 patients with conventional tracheotomy were analyzed including the causes of complications. Results 10 patients was suffered from complications including two cases of intraoperative respiratory and cardiac arrest （1.72%）, three cases of subcutaneous emphysema （2.59%）, two cases of bleeding （1.72%）, two cases of tracheal tube prolapse （I. 72%）, one cases of tracheoesophageal fistula （0.86%）. The complication rate was 8. 62%. Conclusion To grasp the timing of surgery, improve preoperative preparation and recognize anatimic structure care can effectively reduce the tracheostomy complications.