摘要
目的 将经皮穿刺气管切开术与传统气管切开相结合,白创一种创伤小且并发症少的新术式,并探讨其在困难气管切开患者中的应用价值.方法 采用前瞻性研究方法,选择2013年1月至2014年12月在蚌埠医学院第一附属医院重症医学科住院实施困难气管切开的57例患者,按随机数字表法将患者分为小切口手术联合经皮气管切开术组（小切口穿刺术组,25例）和传统气管切开术组（32例）.比较两组患者术中和术后出血量、切口大小、手术时间和切口愈合时间.结果 与传统气管切开术组比较,小切口穿刺术组困难气管切开患者的术中和术后出血量少[术中出血量（mL）：11.36±4.25比23.72±7.29,t=-7.201,P=0.000;术后出血量（mL）：11.60±6.57比26.77±10.77,t=-5.834,P=0.000],切口小（cm：2.20±0.63比4.06±1.19,t=-6.806,P=0.000）,手术时间和切口愈合时间短[手术时间（min）：18.16±3.61比29.09±6.77,t=-7.001,P=0.000;切口愈合时间（d）：4.96±1.59比7.19±2.35,t=-3.975,P=0.000].结论 在困难气管切开患者中,采用小切口穿刺术的气管切开方法较传统气管切开方法操作迅速、创伤小,术中和术后并发症均较少.
Objective To describe an improved percutaneous tracheostomy combined with conventional tracheostomy technique with result of less trauma and fewer complications, and to explore its application in the patients for whom conventional tracheostomy is difficult to perform.Methods A prospective study was conducted.Fifty-seven hospitalized patients, in whom ordinal tracheostomy was difficult to perform, and admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Bengbu Medical College from January 2013 to December 2014 were enrolled.According to the random digital table method, the patients were divided into small incision combined with percutaneous tracheostomy group （small puncture incision group, n =25） and conventional tracheostomy group （n =32）.Amount of blood loss, postoperative bleeding, incision size, operation time and wound healing time were compared between the groups.Results Compared with traditional surgical tracheostomy group, the blood loss and postoperative bleeding were decreased [blood loss （mL）： 11.36 ± 4.25 vs.23.72 ± 7.29, t =-7.201, P =0.000;postoperative bleeding （mL）：11.60 ± 6.57 vs.26.77 ± 10.77, t =-5.834, P =0.000], incision size was smaller （cm： 2.20 ±0.63 vs.4.06 ± 1.19,t =-6.806, P =0.000）, and operation time and wound healing time were shortened [operative time （minutes）： 18.16 ±3.61 vs.29.09±6.77, t =-7.001, P =0.000;incision healing time （days）： 4.96± 1.59 vs.7.19±2.35, t =-3.975,P =0.000] in small puncture incision group.Conclusion Compared with the traditional method, small incision puncture tracheostomy is less time consuming, with fewer traumas, and fewer intraoperative and postoperative complications.
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2015年第11期895-898,共4页
Chinese Critical Care Medicine
基金
安徽省“十二五”临床重点培育专科建设项目（01P44）
关键词
小切口气管切开
经皮气管切开
困难气管切开
Small incision of tracheostomy
Percutaneous tracheostomy
Difficult tracheostomy
