经皮扩张气管切开术与传统式外科开放性气管切开术的对比研究

目的比较经皮扩张气管切开术(Percutaneous D ilative Tracheostomy PDT)和传统式外科开放性气管切开术(OperationalTracheostomy OT)的实用性及特点。方法将32例需机械通气ICU(重症监护室)患者采用不同方法进行气管切开,其中PDT组12例(传统式PDT5例,改良式PDT7例),OT组20例,观察二组的手术切口、手术时间、出血、手术费用及并发症。结果PDT组的手术切口长度、手术时间、术中出血量明显0.05)。PDT组较OT组手术费用明显增加(p<0.05),而改良后的PDT与OT手术费用比较无明显差异(p>0.05)。结论PDT在手术的创伤性、手术时间、减少术中、术后出血上明显优于OT,尤其是改良后的PDT明显降低了手术费用,在患者急救中具有推广应用价值。

Comparative Research between Percutaneous Dilative Tracheostomy and Traditional Operational Tracheostomy

Objective To compare the practicability and characteristics between percutaneous dilative tracheostomy(PDT) and traditional operational tracheostomy(OT).Method Thirty-two ICU cases who needed mechanical ventilation were divided into two groups,PDT group,twelve cases(five cases in traditional type and seven cases in modified type)and OT group,twenty cases.The length of incision wound,duration of operation,amount of haemorrhage,complications and cost were observed respectively in the two groups.Result In PDT group,the length of incision wound,duration of operation,the amount of haemorrage and complications were significantly less than those of the OT group,but the cost of traditional PDT group was a little more(p< 0.05),the cost of modified PDT group had no difference(p>0.05).Conclusion PDT method is more convenient,less traumatic,and less duration of operation and less amount of haemorrhage than those of OT.Especially the modified PDT can decrease cost obviously.It can be widely used in the treatment of emergency patients.