经皮气管切开术与传统气管切开术在ICU的应用体会

目的:探讨经皮气管切开在ICU危重患者抢救的应用价值。方法:回顾性分析144例行气管切开的ICU患者的临床资料。观察经皮气管切开组(79例)和传统气管切开组(65例)的临床症状,对两组患者的手术时间、切口长度、伤口出血、伤口愈合时间和手术并发症进行比较。结果:经皮气管切开组手术时间明显短于传统气管切开组,切口明显小于传统气管切开组,术中出血量明显少于传统气管切开组(P<0.05);皮下气肿、切口感染、切口溢痰、术后出血、套管脱出、气管塌陷、肉芽/疤痕形成和切口愈合时间等并发症的发生率明显少于传统气管切开组,两组比较均有显著性差异(P<0.05)。结论:经皮扩张气管切开术是一种微创的、快捷的急救技术,手术时间短、出血量少、并发症少,适合于ICU的危重患者,能够完全替代传统气管切开术。

Application of Percutaneous Tracheostomy and the Traditional Tracheostomy for Patients in ICU

Objective:To explore the application value of percutaneous tracheostomy for critical patients in ICU.Methods:144 patients with tracheostomy of critical patients in ICU were investigated retrospectively,to observe percutaneous tracheostomy group(PD) and traditional tracheostomy group(OT),the operation time,incision size,amount of bleeding,wound healing time and the incidence of complications were compared between the two methods.Results:When compared with OT group,the operation time in the PD group was shorter,the cutting size was smaller,the amount of bleeding was less(P<0.05).There was a significant difference between the two groups in the incidence of complications(P<0.05),such as subcutaneous emphysema,postoperative infection,incision overflow sputum,postoperative hemorrhage,dislocation of canula,tracheal collapse,granulation and scar formation and the time of wound healing.Conclusion:PD is a kind of minimally invasive and express technique and very suitable for patients in ICU,and PD can replace OT completely.