ICU危重症患者经皮扩张气管切开术的临床应用及护理探讨

目的：探讨ICU危重症患者经皮扩张气管切开术的临床效果及护理方法。方法随机抽取2014年1月至2015年1月住ICU病房的危重症76例患者作为研究对象，按手术方式的不同，将接受传统开放性气管切开术治疗的38例患者作为对照组，将接受经皮扩张气管切开术治疗的38例患者作为观察组，整个围手术期采取相应的护理措施，观察对比两组患者的手术效果，包括手术时间、术中出血量、切口长度、切口愈合时间等，并统计分析两组患者术后并发症发生情况。结果观察组手术时间、术中出血量、切口长度、切口愈合时间均优于对照组，差异有统计学意义( P<0.05)；观察组术后并发症发生率(5.26%)显著低于对照组，差异有统计学意义( P<0.05)。结论对ICU危重症患者采取经皮扩张气管切开术可明显缩短手术时间，同时配合精心细致的护理，可减少术中出血量，促进切口愈合，且安全性好，值得临床推广应用。

Discussion on clinical application and nursing experience of percutaneous dilational tracheostomy in critical patients of ICU

Objective To explore the clinical effect and nursing methods of percutaneous dilational tracheosto-my in critical patients of ICU. Methods A total of 76 cases of critical patients of ICU from January 2014 to January 2015 were randomly collected as the research objects. All of the patients were divided into two groups according to the surgical methods, 38 patients underwent traditional open tracheotomy were as the control group, while 38 patients un-derwent percutaneous dilational tracheostomy were as the observation group. The patients of the two groups all received appropriate nursing measures throughout the perioperative period. The operation effect indexes included operative time, peri-operative bleeding, length of incision, wound healing time, etc. of the two groups were observed and compared, and the postoperative complications were compared. Results The operative time, peri-operative bleeding, length of in-cision and wound healing time of the observation group were significantly better than that of the control group, and the differences were statistical significance ( P<0. 05 ) . The postoperative complication rate of the observation group (5. 26%) was significantly lower than that of the control group, and the difference was statistical significance ( P<0. 05 ) . Conclusions Percutaneous dilational tracheostomy for the treatment of critical patients of ICU can significantly shorten the operation time, and when combined with careful and meticulous nursing can reduce the intraoperative blood loss and promote the wound healing, and has good security, it is worthy of clinical application.