经皮扩张气管切开术在ICU病人人工气道建立中的应用

Application of Percutaneous Dilational Tracheostomy in ICU for Patients Who Need to Establish Air Way

目的探讨经皮扩张气管切开术(PDT)在ICU危重病人人工气道建立中的应用价值。方法80例病人,用经皮扩张法行气管切开术,观察其手术时间、切口大小、术中出血量及各种并发症的发生率和手术死亡率等,与传统的气管切开术进行比较。结果PDT组的手术时间明显短于传统的气管切开术组(P<0.01),手术切口长度也明显短于传统的气管切开术组(P<0.01),出血量明显少于传统组(P<0.01),两组皮下气肿和插管失败、套管脱出、肉芽/疤痕形成等并发症的发生率分别为0、0、0、0和11.25%、11.25%、7.25%、10%,两组比较差异有非常显著性(P<0.05)。而两组的手术死亡率则无显著性差异(P>0.05)。结论经皮扩张气管切开术是一种微创的、快捷的急救技术,适合于ICU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 Di lational Tracheostomy in ICU for patients who need to establish air way. Methods 80 patients were tracheostomize with Percutaneous Dilational Tracheostomy (PDT ) and compared with traditional surgical tracheostomy, in terms of time for oper ation, cutting size, bleeding, occurrence of complication and mortality. Results PDT when compared with the traditional surgical tracheostomy, the time for ope ration was shorter (P<0.01); the cutting size was smaller (P<0.01); the bleeding was less(P<0.01); the rates of skin emphysema, failing of tube insertion, fall out of the insertion tube, and scare formation were lower (0,0,0, and 0 vs 11.25 %,11.25%,7.25%,10% respectively). PDT is obviously better than traditional surg ical tracheostomy. Conclusion PDT is a kind of micro-srugery technique and very suitable for patients in ICU.