肝移植患者的气管切开术

Tracheotomy in patients with liver transplantation

目的:探讨肝移植患者气管切开术的并发症及防治。方法:总结46例肝移植行气管切开术患者的临床资料。结果:46例患者中,25例气管切开术后1个月拔除气管套管,拔管率为54.35%。11例气管切开术区发生术后出血,均止血成功;2例出现皮下气肿;4例发生气管瘘口感染;9例痰液普通细菌培养阳性,无其他手术并发症发生。结论:肝移植患者气管切开术后出血和感染是主要并发症,应对症处理。

Objective： To investigate the indications, complications and their preventions of tracheotomy in patients with liver transplantation. Method：Data of 45 patients with liver transplantation who underwent tracheotomy were summarized. Result：Twenty-five patients（54.350% ） succeeded in removing trachea cannula in one month after tracheotomy. Hemorrhage after tracgheotomy occurred in 11 patients and haemostasis succeeded in all of them. Subcutaneous emphysema occurred in 2 patients. Infection of tracheal fistula occurred in 4 patients. Common bacterial culture of sputum was positive in 9 patients. No other operative complication occurred. Conclusion： Indications of traeheotomy in patient with liver transplantation include respiratory complication and lower respiratory tract infection. Postoperative hemorrhage and infection are the main complications and available measures should be adopted.