经皮扩张气管切开术在凝血功能障碍患者中的应用

Application of Percutaneous Dilational Tracheostomy for Patients Who Are in Coagulation Disorders

目的:探讨经皮扩张气管切开术(PDT)在ICU危重病人凝血功能障碍患者中的应用价值。方法:30例ICU危重病人凝血功能障碍病人,用经皮扩张法行气管切开术,观察其术中术后出血量、手术时间、切口大小及各种并发症的发生率,与传统的气管切开术进行比较。结果:PDT组术中术后出血量明显少于传统气管切开组,手术时间明显短于传统气管切开组、切口明显小于传统气管切开组,两组比较均有显著性差异(P<0.01);皮下气肿、管周溢痰形成明显少于传统气管切开组,两组比较均有显著性差异(P<0.05)。结论:经皮扩张气管切开术适合于ICU凝血功能障碍的危重病人,在ICU人工气道建立中有较大的应用价值。

Objective ： To explore the application value of Percutaneous Dilational Tracheostomy in ICU for heavy patients who are in coagulation disorders. Methods： 30 heavy patients with coagulation disorders were tracheostomized with Pereutaneous Dilational Tracheostomy （PDT）and compared with traditional surgical tracheostomy, in terms of time for operation, cutting size, bleeding, occurrence of complication and mortality. Results： PDT when compared with the traditional surgical tracheostomym, the bleeding during and after operation was less（P〈0.01 ） ; the time for operation was shorter （P〈0.01） ; the cutting size was smaller（P〈0.01 ） ; skin emphysema,sputum extending pulse around the trachea were lower （P〈0.05）. Conclusion： PDT is very suitable for patients who are in coagulation disorders in ICU, and has good application value in establishment of artificial airway in ICU.