床边经皮旋转扩张气管套管置入术的疗效观察

Clinical observation of the curative effect of percutaneous dilatational tracheotomy beside bed

目的:观察床边经皮旋转扩张气管套管置入术(PDT)的临床疗效。方法:将100例具有气管切开适应证的ICU危重病患者随机分成PDT组和CT组,每组50例。PDT组在床边无内窥镜引导下经皮旋转扩张气管套管置入术;CT组采用传统的外科经典手术行气管套管置入。比较两组手术操作时间、出血量、切口的大小以及相关并发症和安全性等差异。结果:PDT组操作时间(8.2±1.3)分钟、术中出血量(1.8±0.2)ml、切口(0.8±0.1)cm及术后并发症发生率等均明显低于CT组。结论:PDT具有微创、组织损伤小、出血量少、扩张过程中可控性强、操作时间短、并发症发生率低等优点,只要规范操作,在无纤维支气管镜引导下同样可取得满意的临床效果。

Objective：To observe the clinical effect of the percutaneous dilatational tracheotomy （PDT） beside bed （without the guidance of endoscope）.Methods：100 critical patients with tracheotomy indication in our department of intensive care unit （ICU） were randomly divided into the PDT group and classical tracheotomy （CT） group,with 50 cases in each group.The PDT group was adopted with PDT without the guidance of endoscope,while the CT group with surgical classical method.The operative time,volume of bleeding,size of incision,complication and safety of operation were compared between two groups.Results：Th operative time （8.2 ±1.3）min,volume of bleeding （1.8±0.2）ml,size of incision （0.8±0.1）cm and the incidence of postoperative complication in the PDT group were all significantly lower than those in the CT group（P〈0.01）.Conclusion：PDT is safe and easy to operate,with short time,less trauma and few complications.It can similarly achieve the satisfactory clinical effect without the guidance of endoscope if the operation is normalization,and is worth to extend.