血液病患者气管切开术的探讨

目的：探讨血液病患者行气管切开术的可行性、手术方法及注意事项。方法：1993至2003年对17例住院血液病患者行常规气管切开术，根据患者病情，配合常规气管切开术分别采取相应的措施，如术前成分输血，手术创面凝血酶纱条填塞止血，创面出血较多的患者采取进气管前气管插管或术前气管插管等。结果：17例患者全部成功实施气管切开术，除1例于术后4h因其他血液病并发症死亡外，余者均存活3个月以上。结论：感染与出血是血液病患者实施气管切开术的主要危险因素，及时把握手术时机，严格规范操作，并根据病情配合相应的综合措施，是手术成功的关键。

Tracheotomy in patients with hematological disease

Objective:To explore the feasibility,procedure and attention of tracheotomy for patients with hematological disease.Methods:Seventeen cases with hematological disease from 1993 to 2003 were treated by conventional tracheotomy with the relevant synthetical measures, such as transfusing component blood before surgery, thombinase filling up the surface of wound, tracheal intubation before cutting open the trachea or before the surgery and so forth.Results:All had succeeded in carrying out tracheotomy and survived over 3 months,except that one case died of other complication of hematopathy 4 hours after surgery. Conclusion: Infection and hemorrhage are the main risk factors of tracheotomy in hematological disease. Preoperative evaluation,timely tracheotomy and synthetical measures are very important for the patients.