经皮扩张气管切开术在危重病患者抢救中的应用价值

Clinical Application of Percutaneous Dilatational Tracheostomy in Critical Patients

目的：总结经皮扩张气管切开术（PDT）在抢救ICU重症患者中的应用经验。方法：选取2007年1月～2011年12月215例经皮扩张气管切开术患者为PDT组，随机选取2003年1月～2011年12月我院ICU传统开放性气管切开术患者200例为OT组，比较两组的手术时间、切口大小、术中出血量及术后并发症。结果：PDT组手术时间为（8．41±2．31）rain、切口长度为（1．52±0．39）cm、术中出血量为（8．03±2．46）ml，明显低于OT组的（15．02±5．23）min、（4．04±0．24）cm、（15．01±3．22）fnJ，差异均有统计学意义（P〈0．01）；切口出血、皮下气肿等术后并发症率也明显低于OT组（P〈0．01）。结论：经皮扩张气管切开术PDT具有省时、创伤小、并发症少等优势，对救治重危病人具有较大的应用价值。

Objective：To summarize the clinical experience of percutaneous dilatational tracheostomy （PDT） in critical ICU patients. Methods ：From January 2007 to December 2011,215 patients of percutaneous dilatational tracheotomy was the PDT group, 200 patients with randomized from January 2003 to December 2011 ICU traditional open tracheostomy was the OT group. The operative time, incision size, blood loss and postop- erative complications in the two groups were compared. Results：The operative time in PDT group was （8.41 ± 2.31 ） min, the incision length was （ 1.52 ± 0.39） cm and the blood loss was （ 8.03 ± 2.46） ml, significantly lower than those in the OT group, （ 15.02± 5.23 ） rain, （4.04 ±0.24） era, （ 15.01± 3.22） ml, the differ- ences were statistically significant （ P 〈 0.01 ） ; the postoperative complication rate such as the wound bleeding, subcutaneous emphysema was lower than that in the OT group （ P 〈 0.01 ）. Conclusions ： Percutaneous dilata- tional tracheostomy has time - saving, little trauma, fewer complications and other advantages; it has great clin- ical application value to treat the critically ill patients.