危重症患者经皮气管切开术和传统外科气管切开术疗效的对比研究

Percutaneous Dilatational Tracheotomy and Surgical Tracheotomy in Critical ILL Patients: A Comparative Analysis of Effects

目的比较经皮气管切开术(PDT)和传统外科气管切开术(ST)治疗危重患者的疗效及安全性。方法回顾性分析47例PDT患者(PDT组)和24例ST患者(ST组)的手术时间、术中出血量、切口大小、切口愈合时间和并发症发生率。结果 PDT组患者较ST组患者的手术时间〔(6.2±1.2)min与(21.0±4.8)min〕短、切口〔(1.7±0.3)cm与(3.9±0.8)cm〕小、术中出血量〔(4.6±0.9)ml与(9.0±4.0)ml〕少、切口愈合时间〔(3.0±0.9)d与(6.0±1.1)d〕短,且差异均有统计学意义(P<0.05);PDT组患者除切口渗痰发生率(0)较ST组〔4/24(16.7%)〕低,且差异有统计学意义(P<0.05)外,其余并发症发生率比较,差异均无统计学意义(P>0.05)。结论 PDT较传统的ST手术时间短、出血少、切口小、愈合快,且切口渗痰的发生率低,可推广应用于危重症患者。

Objective To compare the efficacy and safety of percutaneous dilatational tracheotomy（PDT） with those of surgical tracheotomy（ST） in critical ill patients.Methods The operation time,amount of blood loss,size of operative incision,incision healing time,incidence of complications were analyzed retrospectively in 47 patients with PDT and 24 with SCT.Results The operation time was shorter in PDT group than in ST group 〔（6.2 ± 1.2） min vs.（21.0 ± 4.8） min〕,size of operation incision smaller 〔（1.7 ± 0.3） cm vs.（3.9 ± 0.8） cm〕,blood loss lower 〔（4.6 ± 0.9） ml vs.（9.0 ± 4.0） ml〕,incision healing time shorter 〔（3.0 ± 0.9） d vs.（6.0 ± 1.1） d〕,the difference was significant（P〈 0.05）.Incidence of incision sputum leaking was lower in PDT group（0） than in ST group（16.7%）,the difference was significant（P〈 0.05）,but no difference was noted in incidence of the other complications（P〈 0.05）.Conclusion PDT,with shorter operation time,less blood loss,smaller incisions,faster healing,lower incision sputum leaking than those of traditional ST,can be applied in critically ill patients.