经皮微创气管切开术在ICU中的临床应用

目的 评价经皮微创气管切开术(PDT)在ICU危重病人救治中的临床应用价值.方法 我院ICU符合气管切开指征无禁忌证的患者70例,随机分为经皮微创气管切开术组(PDT组)29例和传统开放式气管切开术组(OT组)41例,比较两组间在手术时间、切口大小、出血量、并发症等方面的差异.结果 PDT组手术时间较OT组明显缩短(11.28±3.48 min VS 22.95±4.67 min,P=0.00);切口明显减小(1.60±0.21 cm VS 4.09±0.74 cm,P=0.00),出血量(6.46±3.74 ml VS 26.68±11.07 ml,P=0.00)及切口感染机率较OT组明显减少(0% VS 14.6%,P=0.031),差异均有统计学意义(P＜0.05).结论 PDT具有省时、创伤小、并发症低等优势,对救治重危病人具有较大的应用价值.

Clinical application of percutaneous dilational tracheostomy in ICU

Objective To evaluate the clinical value of percutaneous dilational tracheostomy(PDT)in intensive care unit(ICU).Methods A Prospective study was done.Seventy patients in ICU were studied from November 2009 to January 2011.The patients were randomly divided into PDT group(29 cases) and OT group(41 cases).The patients in PDT group underwent percutaneous dilational tracheostomy and others were operated open tracheostomy.The datas of two groups were compared in operative time,cutting sizes,blood loss and the incidence of surgical complications.Results The numerus of the operative time,cutting sizes,blood loss were less in PDT than that of OT group(11.28±3.48 min VS 22.95±4.67 min,P=0.00;1.60±0.21 cm VS 4.09±0.74 cm,P=0.00;6.46±3.74 ml VS 26.68±11.07 ml,P=0.00).And the ratio of infection in PDT group was significant lower than in OT group(0% VS 14.6%,P=0.031).Conclusion The percutaneous dilational tracheostomy is a minimally invasive,quick first aid techniques for critically ill patients in ICU,The rate of complication is low.The application value of percutaneous tracheostomy is high.