经皮微创气管切开加声门下吸引应用于老年患者效果观察

Evaluations of percutaneous dilatational tracheostomy with continuous aspiration of subglottic secretions in intensive care elder patients

对32例需长期机械通气的ICU老年患者采用经皮微创气管切开术（PDT），取同期36例传统气管切开术（TST）作对照，PDT组手术时间短于TST组[（10．6±3．4）min和（30．9±7．1）min，P〈0．01]；PDT组切口长度小于TST组[（1．3±0．2）cm和（3．2±0．3）cm，P〈0．01]；PDT组出血量小于TST组[（10．4±3．8）ml和（40．7±11．7）ml，P〈0．01]；PDT组呼吸机相关性肺炎发生率低于PDT组（15．6％和38．9％），P〈0．05。PDT适用于需长期机械通气的老年患者。

To evaluate percutaneous dilatational traeheostomy （PDT） with continuous aspiration of subglottic secretions in intensive care unit （ ICU ） elder patients. A total of 32 elder patients were selected randomly for PDT and 36 controls for traditional surgical tracheostomy （ TST）. The PDT group required regular mechanical ventilation with continuous aspiration of subglottic secretions. The operative duration was significantly shorter in PDT group than that in TST group [ （ 10. 6 ± 3.4 ） vs. （30. 9± 7. 1 ） min, P 〈 0. 01 ]. Incision length was significantly less in PDT group than that in TST group [ （ 1.3 ± 0. 2 ） vs. （ 3.2 ±0. 3 ） cm, P 〈0. 01 ]. Blood loss volume was significantly less in PDT group than that in TST group [ （10. 4 ± 3.8）vs. （40. 7 ± 11.7） ml, P 〈 0. 01]. The incidence of ventilator associated pneumonia （VAP） was significantly lower in PDT group than that in TST group （ 15.6% vs. 38.9%, P 〈 0. 05 ）. With multiple advantages of mini-invasiveness, safety, simplicity, convenience and easier installation, PDT is quite suitable for elder patients in ICU.