紧急气管切开患者的临床特点分析

Clinical analysis on 45 cases of urgent tracheotomy

目的:探讨紧急气管切开患者的临床特点。方法:对45例患者的临床资料进行回顾性分析,分析其疾病特点、术前术后临床表现以及并发症。行紧急气管切开患者多见于肿瘤疾病(19例),非瘤性梗阻以头颈外伤(15例)和炎症性疾病(8例)为主。结果:2例患者术中死亡,2例患者术后死亡;呼吸困难明显、梗阻时间长的6例患者切开后发生了呼吸抑制;11例患者术中或术后出现并发症,出血、皮下气肿和局部副损伤是紧急气管切开的主要并发症。结论:紧急气管切开患者的状况不同于常规气管切开患者,术中时间短且多为自然体位,技术难度大,并发症的发生率高于常规气管切开者。长时间梗阻切开后不宜马上吸入纯氧,以防止出现呼吸抑制。

Objective.. To investigate the clinical characteristics of urgent tracheotomy patients. Method： Forty- five cases of urgent tracheotomy patients were reviewed retrospectively. The clinical characteristics, ore-operative and post-operative clinical manifestation and complication were studied. Most patients for urgent tracheotomy were head and neck tumor, inflammation and head and neck injury. Result： Two patients died in operating and two pa- tients died in post-operation. Finding respiratory depression in six patients of long obstruction in post-operation. Eleven patients had complication in operating or post-operation. Hemorrhage and pneumoderma and local trauma were the main complications. Conclusion. Emergent tracheotomy and elective tracheotomy were different-in the short operation time and body position. Complication incidence rate were higher than normal tracheotomy. Pa-tients of long obstruction after post-operation shouldn＇t breathe in pure dephlogisticated air to avoidance respiratory depression.