经皮气管切开术在ICU应用价值探讨

Clinical application of percutaneous tracheostomy in ICU

目的观察经皮扩张气管切开术在危重患者的临床疗效。方法41例患者采用经皮扩张气管切开术,另36例采用传统气管切开术,比较经皮气管切开术和传统气管切开术的手术时间、术中及术后出血量,以及从决定气管切开到实施气管切开的时间。结果在危重患者中,经皮气管切开术手术时间明显缩短,术中及术后出血量明显减少,差异有统计学意义(P<0.001)。特别从决定气管切开到实施气管切开的时间,经皮气管切开术比较传统气管切开术明显缩短,差异有统计学意义(P<0.001)。结论经皮扩张气管切开术具有简单、快速、损伤小的特点,在ICU缩短从决定气管切开到实施气管切开的时间,避免延误气管切开时机,可提高内科ICU医师气道管理的主动性,可以作为ICU医生标准治疗技术。

Objective To summarize the application of percutaneous tracheostomy in intensive care unit（ICU）.Methods A retro-spective study of 41 patients who had percutaneous tracheostomy by Portex equipment was undertaken in ICU.Results The procedure was successful in 41 patients.A decision of shorter duration was made by ICU doctors than by otolaryngologists,and the time for operation procedure is shorter than the traditional tracheotomy.Exudative hemorrhage is minor,without severe complications.Conclusion Percutaneous tracheostomy is more quick,safe and simple,with minor injury,which can be standard tracheotomy in ICU.