摘要
目的探讨危重肥胖患者实施气管切开术行机械通气的临床效果及并发症。方法根据40例肥胖患者的主观意愿及病情,采取常规局麻下气管切开术13例,全麻插管下气管切开术27例。结果皮下气肿15例,术中出血6例,气胸2例,手术并发症率为55.0%,死亡5例,病死率12.5%。死因为术中呼吸窒息2例,心搏骤停2例,麻醉插管意外1例。术后随访资料完整者33例,综合判断,手术效果良好。结论对危重肥胖患者,早期行气管切开术是安全之策,麻醉插管下行气管切开术是较好的方法。
Objective To investigate the clinical result and complications of mechanical ventilation by tracheoctomy in patients with serious obesity. Methods In 40 serious obesity patients 13 were given tracheotomy under the conventional local anethethesia, and 27 were given tracheotomy under general anesthesia with intratracheal intubation basing on the patients＇ intention and their condition. Results there were 15 cases with subcutaneous emphysema, 6 cases with hemorrhage during operation, and 2 cases with pneumothorax, the ratio of operative complications was up to 55.0%. There were 5 cases that died ; the rate of mortality was 12.5%. The causes of death were suffocating （2 cases）, heart arrest （2 cases） and accident in anesthesia intubation （ 1 case）. The cases that had a complete data of postoperative follow-up were of 33, the operative effect was good by comprehensive assessment. Conclusion It is safety to operate early on serious obesity patients by tracheotomy. Tracheotomy under anesthesia with intratracheal intubation on serious obesity patients is a better choice.
出处
《中国全科医学》
CAS
CSCD
2008年第13期1188-1189,共2页
Chinese General Practice
关键词
肥胖症
气管切开术
手术后并发症
插管法
气管内
Obesity
Tracheotomy
Postoperative complications
Intubation intratracheal
