经皮扩张与常规气管切开术在重型颅脑损伤昏迷病人中的应用比较

Clinical comparisons between percutaneous dilational tracheostomy and open tracheostomy in coma patients with severe craniocerebral injury

目的:通过比较开放式气管切开术(OT)和经皮扩张气管切开术(PDT)在重型颅脑损伤昏迷病人中的应用情况来评价PDT的临床应用价值。方法:采取前瞻性随机性研究方法比较PDT组和OT组在住院期间的并发症发生率及操作时间。结果:PDT组的并发症发生率明显低于OT组(P<0.05)。PDT组平均操作时间为(7.8±2.9)min,OT组为(21.3±4.2)min。PDT组操作时间明显比OT组短(P<0.01)。结论:PDT操作简单快速,并发症少,可由神经外科医师独立完成,在重型颅脑损伤昏迷病人中有较广泛的应用价值。

Objective： To evaluate the clinical values of the PDT（percutaneous dilational tracheostomy） by comparing the PDT with the OT（open trscheostomy）in unconscious patients with severe craniocerebral injury. Methods： A prospective randomized study was undertaken to compare the rate of complications and operation time from tracheostomy to discharge between PDT and traditional OT group. Results. The rate of complications in the PDT group was significantly lower than the OTgroup. Mean operation time of the PDT group was significantly shorter than that of the OT group. （21. 3±4.2 minutes and 7.8±2.9 minutes respectively. ） Conclusions： PDA is superior to OT in terms of the ease of performance and the rate of complications. It can be used on the patients of severe craniocerebral injury.