纤维支气管镜下经皮扩张气管切开术在口腔颌面外科的应用

Clinical application of fiberoptic bronchoscopy-assisted percutaneous dilatational tracheostomy in oral and maxillofacial surgery

目的:探讨纤维支气管镜引导下经皮扩张气管切开术在口腔颌面外科的应用价值。方法:选择因手术需要行预防性气管切开的口腔颌面外科患者60例,随机分为3组(n=20):经典手术气管切开组(A组)、经皮扩张气管切开组(B组)、纤维支气管镜引导下经皮扩张气管切开组(C组)。观察并记录3组的气管切开操作时间、出血量、一次性置管成功率、血氧饱和度(SpO2)变化和并发症的差异。采用SPSS 17.0软件包对数据进行统计学分析。结果:与经典手术A组相比,B组和C组在气管切开中的操作时间显著缩短,出血量和并发症减少,一次性置管成功率显著提高(P<0.05)。与B组相比,C组在操作时间上显著减少,一次性置管成功率显著提高(P<0.05)。结论:纤维支气管镜引导下经皮扩张气管切开术安全有效,在口腔颌面外科手术中有较高的应用价值。

PURPOSE： To investigate the clinical value of fiberoptic bronchoscopy-assisted percutaneous dilatational tracheostomy in oral and maxillofacial surgery.METHODS： Sixty patients who needed prophylactic surgical tracheotomy in oral and maxillofacial surgery were randomly divided into 3 groups（n=20）：Classic surgical tracheotomy group（group A）,percutaneous dilational tracheostomy group（group B） and fiberoptic bronchoscopy-assisted percutaneous dilational tracheostomy group（group C）.The timing of procedure,hemorrhage,one-time successful rate,SpO2 changes and complications in three groups were recorded and analyzed with SPSS 17.0 software package.RESULTS： Compared with group A,group B and group C had a shorter time of procedure,less bleeding,higher one-time successful rate and lower complications（P0.05）.Compared with group B,the time of procedure reduced and the one-time successful rate increased significantly in group C（P0.05）.CONCLUSION： The safety and efficiency with fewer complications of fiberoptic bronchoscopy-assisted percutaneous dilatational tracheostomy make it valuable in oral and maxillofacial surgery.