摘要
目的观察经皮气管切开术与传统气管切开术术后并发症的异同并分析原因。方法采用前瞻性研究,将200例神经外科需要行气管切开术患者随机分为经皮气管切开术组和传统气管切开术组,每组各100例。统计两组两周内术后并发症数据。结果术后两周经皮气管切开术术后出血15例,皮下积气2例,切口感染2例,并发症总计19例;传统气管切开术出血4例,皮下积气3例,切口感染1例,并发症总计8例。两组术式术后出血发生率经比较具有统计学意义(P<0.05),两组术式术后皮下积气及切开感染发生率经比较均无统计学意义(P均>0.05),两组术式术后并发症总发生率存在明显差异,经比较具有统计学意义(P<0.05)。结论神经外科患者行经皮气管切开术早期术后并发症风险高于传统气管切开术。病情危重需要紧急开放气道的患者优先选用经皮气管切开术,肥胖颈短、病情相对平缓,无需立即开放气道的患者优先选用传统气管切开术。
ObjectiveTo observe the differences and similarities of complications between percutaneous tracheotomy and traditional tracheotomy and to analyze the reasons.MethodsA prospective study was conducted to 200 neurosurgical patients who needed tracheotomy. They were randomly and equally divided into percutaneous tracheotomy group and traditional tracheotomy group. The data on postoperative complications in both groups were calculated within two weeks after surgery.ResultsComplications occurred in 19 cases of the percutaneous tracheotomy group, including postoperative hemorrhage in 15, subcutaneous emphysema in 2, and incision infection in 2. As for the traditional tracheotomy group, the complications occurred in 8 cases, including hemorrhage in 4, subcutaneous emphysema in 3, and incision infection in one. Statistical analyses showed significant difference of postoperative hemorrhage （P〈0.05）, and insignificant differences of subcutaneous emphysema and incision infection between the two groups （both P〉0.05）. The analyses also revealed that the difference of complication rate between both groups was statistically significant （P〈0.05）.ConclusionsThe risk of early postoperative complications of percutaneous tracheotomy was higher than that of traditional tracheotomy in neurosurgical patients. For the patients who need urgent tracheotomy, percutaneous tracheotomy is preferable. Otherwise, traditional tracheotomy is preferred, particularly for obese ones with short neck or relatively stable condition.
作者
胡均贤
赵德英
袁玉明
徐春林
HU Jun-xian;ZHAO De-ying;YUAN Yu-ming;XU Chun-lin(Department of Neurosurgery, Center Hospital of Huanggang City, Huanggang 438000, Chin)
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2018年第3期284-287,共4页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
关键词
气管切开术
并发症
神经外科
临床应用
Tracheotomy
Complication
Neurosurgery
Clinical application
