床旁B超联合纤支镜直视下经皮扩张气管切开术在危重病中的应用

目的探讨在床边B超联合纤支镜直视下经皮扩张气管切开术在危重病中的临床应用价值。方法回顾性分析重症监护病房(ICU)中气管切开的危重病患者共138例,其中常规外科气管切开术组33例,单纯经皮扩张气管切开术组51例,床边B超联合纤支镜直视下经皮扩张气管切开术组54例,比较三组手术操作时间、术中出血量、切口大小以及术中、术后并发症发生率。结果床边B超联合纤支镜直视下经皮扩张气管切开术组与单纯经皮扩张气管切开术组、常规外科气管切开术组相比,操作时间、术中出血量、手术切口大小、术中术后并发症发生率明显降低。结论床边B超联合纤支镜直视下行经皮扩张气管切开术可以明显降低手术时间、出血量、术中以及术后并发症的发生率,提高手术成功率,可以广泛应用于ICU中的危重病患者。

Application of bedside type-B ultrasonic combined with fibrobronchoscopeguided percutaneous dilational tracheostomy for critical illness

Objective To investigate the application value of bedside type-B ultrasonic combined with fibrobronchoscope-guided percutaneous dilational tracheostomy for critical illness. Methods 138 cases of tracheotomy in intensive care units(ICU) were retrospective analyzed,33 paitents of them underwent conventional tracheotomy,51 cases of simple percutaneous dilational tracheostomy,54 cases of bedside type-B ultrasonic combined with fibrobronchoscope-guided percutaneous dilational tracheostomy.The operation time,blood loss,incision size and the incidence of postoperative complications were compared in three groups. Results The operation time,blood loss,incision size and the incidence of postoperative complications in bedside type-B ultrasonic combined with fibrobronchoscope-guided percutaneous dilational tracheostomy group were significantly lower than other two groups. Conclusion Bedside type-B ultrasonic combined with fibrobronchoscope-guided percutaneous dilational tracheostomy can significantly reduce the operation time,blood loss,incision size and the incidence of postoperative complications to improve the success rate of surgery.It can be extensive used to treat critical patients in ICU.