经皮气管切开术在神经重症患者救治中的效果分析

目的探讨经皮气管切开术（Percuta—neousDilationalTracheostomy，PDT）与传统气管切开术在神经重症患者救治中的优劣。方法回顾2012年2月一2013年2月在我院住院的76例需行气管切开的急性神经重症患者，其中经传统手术气管切开19例，经皮气管切开57例，术前、术后采用美国国立卫生研究院卒中量表（NIHStrokeScale，NIHSs）和格拉斯哥昏迷评分法（GCS，GlasgowComaScale）二种神经评分系统进行神经功能评价，观察比较手术操作时间，出血量、气胸、皮下气肿、气管瘘、食管损伤以及肺部感染等并发症的发生率。结果经皮气管切开_术在手术时间上明显优于传统气管切开术，术中、术后并发症的发生率低于传统气管切开术。结论经皮气管切开术有效快速建立神经重症患者的气道，操作简便、安全，降低呼吸系统感染并发症的发生率。

CLINICAL EFFECT OF PERCUTANEOUS TRACHEOTOMY IN TREATMENT OF CRITICALLY ILL NEUROLOGICAL PATIENTS

Objective To investigate the effect of percutaneous tracheostomy （Percuta- neous Dila- tional Tracheostomy,PDT） and traditional tracheotomy in the treatment of severe patients of nerve. Methods The data of 76 patients with severe acute nerve tracheotomy were analyzed retrospectively from February 2012 to February 2013 in author＇s hospital, including 19 cases of traditional tracheoto- my and 57 cases of percutaneous tracheotomy. All subjects were performed a preoperative and postop- erative neurologic functional evaluation by using the United States National Institutes of Health Stroke Scale （NIH Stroke Scale,NIHSS） and the Glasgow coma scale （GCS,Glasgow Coma Scale）. The inci- dence was observed and compared on operation time, amount of bleeding, subcutaneous emphysema, pneumothorax, tracheal fistula, esophageal injury and complication of pulmonary infection. Results Percutaneous tracheostomy on operation time was obviously superior to the traditional tracheotomy, postoperative complications occurrence rate was also lower than the traditional tracheotomy. Conclusion Percutaneous tracheostomy can effective rapid establish airway of severe neurologic patients with a simple and safety operation, lower incidence of complications of respiratory system infection.