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微创气管切开在神经外科危重患者抢救中的应用 被引量:8

Application of Percutaneous Dilational Tracheostomy in Emergency Treatment of Critically Ill Neurosurgical Patients
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摘要 目的探讨和推广经皮微创气管切开术(percutaneous dilatational tracheostomy,PDT)在神经外科危重患者救治中的临床应用。方法回顾分析2009年10月至2011年12月181例行PDT危重患者的临床资料,均为直接切开,二次切开2例。观察其手术时间、切口大小、术中出血及各种并发症的发生率和手术死亡率、拔管时间及切口愈合等情况。结果 181例患者中2例出现术中明显出血,1例气管套管插入右主支气管内,1例在术中出现呼吸、心跳骤停经抢救后无效死亡,1例拔管后咽部有异物感,1例因肉芽瘢痕镶嵌于切口致延迟愈合。余无其他严重并发症发生。结论经皮微创气管切开术具有微创、快速、可单人操作、成功率高、并发症少等优势,可以提高神经外科危重患者的救治率。 Objective To explore and promote the clinical application of percutaneous dilatational tracheostomy(PDT) in emergency treatment of critically ill neurosurgical patients.Methods A retrospective analysis was performed in 181 critically ill neurosurgical patients who underwent PDT between October 2009 and December 2011.Direct tracheotomy was performed in all patients(second incision in 2 patients).The operation time,incision size,intraoperative blood loss,incidence of complications,mortality,time to extubation and wound healing were observed.Results Among the 181 patients,intraoperative bleeding occurred in 2 patients,tracheal tube was inserted into the right main bronchus in 1 patient,1 patient died due to intraoperative respiratory and cardiac arrest,1 patient had pharyngeal foreign body sensation after extubation,and 1 patient had delayed healing 1 because of granulation scar mosaic at the incision.No other serious complications occurred in patients.Conclusion The PDT can increase the cure rate in critically ill neurosurgical patients,with the advantages of minimal invasion,short operation time,simple manipulation,high success rate and few complications.
出处 《南昌大学学报(医学版)》 CAS 2012年第11期37-39,共3页 Journal of Nanchang University:Medical Sciences
关键词 微创气管切开 神经外科 人工气道 抢救 percutaneous dilatational tracheostomy neurosurgery artificial airway emergency treatment
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