经皮微创气管切开术对喉癌病人临床疗效及应激指标的影响

目的探讨经皮微创气管切开术对喉癌病人临床疗效及应激指标的影响。方法选取120例行喉功能保全术的喉癌病人作为研究对象，按照随机数字法将所有病人分为对照组与观察组，各60例。对照组接受传统气管切开术治疗，观察组行经皮微创气管切开术治疗。比较2组血液动力学指标、手术情况、应激反应指标以及术后并发症等指标。结果2组T₂、T₃、T₄、T₅时间点收缩压、舒张压、心率和呼吸频率较T1时间点均显著升高，前后比较差异具有统计学意义（P < 0.01）；与对照组相比，观察组T₂、T₃、T₄、T₅时间点收缩压、舒张压、心率和呼吸频率均明显低于对照组（P < 0.01）。观察组微创气管切开术时间、切口大小、术中出血量、切口愈合时间均显著低于对照组（P < 0.01）。2组T'₂、T'₃、T'₄时间点应激反应指标（血糖、皮质醇、IL-6和C反应蛋白）较T'₁时间点均显著升高，前后比较差异具有统计学意义（P < 0.05~P < 0.01）；与对照组相比，观察组T'₂、T'₃、T'₄时间点应激反应指标（血糖、皮质醇、IL-6和C反应蛋白）均明显低于对照组（P < 0.05~P < 0.01）。观察组不良反应发生率及术后皮肤凹陷率均明显低于对照组（P < 0.01）。结论采用经皮微创气管切开术对喉癌病人进行治疗效果显著，操作简单，减少术中出血以及手术时间，能够有效降低病人应激反应指标和术后不良反应概率，避免术后皮肤凹陷。

Influence of minimally invasive percutaneous tracheotomy in the treatment of laryngeal cancer on the clinical effect and stress response of patients

ObjectiveTo explore the influence of minimally invasive percutaneous tracheotomy in the treatment of laryngeal cancer on clinical effect and stress response of patients.MethodsOne hundred and twenty patients with laryngeal cancer were randomly divided into the control group(60 cases) and observation group(60 cases).The control group was treated with conventional tracheotomy, and the observation group was treated minimally invasive percutaneous tracheotomy.The level of blood rheology, operation, stress response index and postoperative complications between two groups were compared.ResultsAt T₂, T₃, T₄ and T5, the SBP, DBP, HR and breathing rate in two groups significantly increased compared with at T₁, and the differences of those among different time-points were statistically significant(P < 0.01).The SBP, DBP, HR and breathing rate in observation group at T₂, T₃, T₄ and T₅ were significantly lower than those in control group(P < 0.01).The operation time, incision length, intraoperative blood loss and wound healing time in observation group were significantly lower than those in control group(P < 0.01).The levels of blood glucose, cortisol, IL-6 and and CRP significantly increased in two groups at T'₂, T'₃ and T'₄, and the differences of those among different time-point were statistically significant(P < 0.05 to P < 0.01).The levels of blood glucose, cortisol, IL-6 and and CRP in observation group were significantly lower than those in control group(P < 0.05 to P < 0.01).The incidence rate of postoperative complications and skin dent rate in observation group were significantly lower than that in control group(P < 0.01).ConclusionsThe minimally invasive percutaneous tracheotomy in treating laryngeal cancer has good effect and simple operation, which can significantly decrease intraoperative blood loss, operation time, stress response indicators and postoperative complications, and avoid postoperative skin dents.