气管切开术后并发出血14例

目的 探讨行气管切开术后并发出血的原因及处置方法。方法 14例发现气管切开术切口出血后患者，部分经确保无血液进入气管内情况下，局部给予凡士林纱条压迫，2d后撤出纱条；其余经凡士林纱条压迫无效，打开伤口探查，对出血点结扎、缝扎出血点，双极电凝止血，缝合套管上方皮肤，观察出血情况。结果 气管切开术后出血发生的时间范围较大，且出血原因较多，以肥胖、颈部短粗患者位多；且原因以甲状腺包膜损伤为多。 结论 气管切开术并发出血原因较多，且出血时间不定，后果严重，应积极须防，及时诊断，及时处理。

Hemorrhage after tracheotomy in 14 cases

Objective To analyze the causes of incision hemorrhage after tracheotomy and to propose the treatment. Methods 14 cases had incision hemorrhage after tracheotomy. Some cases were treated by local packing with Vaseline gauzes when no blood entered trachea and all the bleedings were contained. 2 days later, Vaseline gauzes were removed without rehemorrhage. For the patients in whom packing was not effective, we probed the incisions to ligate or cauterize the hemorrhagic spots. Then, we sutured the skin incisions to monitor the progress. Results After tracheotomy, the causes and time points of hemorrhage varied， most cases had a fat and short neck. Lots of hemorrhage was due to the injures to thyroid gland. Conclusions The causes and time points of hemorrhage are various.Serious consequences may occur. Therefore, we should treat it timingly and actively.