经皮扩张气管切开术在ICU中的应用

目的探讨经皮扩张气管切开术(PDT)在ICU中的应用价值。方法连续性选择56例入住重症监护病房(ICU)需机械通气的重症患者,根据气管切开方式的不同分为PDT组31例,OT组(开放性气管切开术)25例,观察2组手术切口长度、手术时间、术中出血、术中缺氧时间及手术相关并发症。结果 PDT组手术切口长度(15.0±1.6)mm、手术时间(9.9±3.4)rain、出血量(5.2±2.2)ml、术中缺氧时间(10.2 4～2.1)s,均小于OT组的(41.2±3.9)mm、(27.2±5.1)min、(18.2±3.5)ml、(31.1±6.2)s,差异均有统计学意义(P值均<0.01);切口出血、皮下气肿等并发症显著降低(P值均<0.05)。结论经皮扩张气管切开术简单、快捷,并发症少,在危重症患者中值得推广应用。

Application of percutaneous dilational tracheostomy in ICU

Objective To study the clinical value of percutaneous dilational tracheostomy （PDT） in ICU. Methods 56 critical patients who needed mechanical ventilation hospitalized in ICU were includeded and divided into two groups： PDT group, 31 cases and 0T groups,25 cases. The length of incision, duration of operation, amount of haemorrhage and complications were observed. Results The operation time was significantly shortened （ 9.9 ± 3.4 ） minutes vs （ 27.2 ± 5.1 ） minutes ], blood loss was significantly decreased （ 5.2 ±2.2） ml vs （ 18.2 ± 3.5 ） ml ] ,length of incision was significantly shortened （ 15.0 ±- 1.6 } mm vs （41.2 ± 3.9 ） mm ], and lacking oxygen time was significantly shorter （ 10.2 ± 2.1 ） seconds VS （ 31.1 ± 6.2 } seconds ] in PDT group compared with OT group （ all P 〈 0.01 ）. PDT had less subcutaneous emphysema and incision bleeding in PDT group than those in OT group （ all P 〈 0.05 ）. Conclusion PDT is easier in performance with less complications, and is deserved to be applied in critical patients.