经皮扩张气管切开术在综合ICU中的临床应用

Clinical Application of Percutaneous Dilational Tracheostomy in the Central ICU

目的:探讨经皮扩张气管切开术(Percutaneous dilational tracheostomy,PDT)在综合ICU危重患者人工气道建立中的临床应用价值。方法:选取本院综合ICU在2011年3月-2013年10月开展PDT术的48例患者,并选取同期行传统气管切开术(Open tracheostomy,OT)的45例患者作为对照,观察比较两组术中、术后的一般情况及并发症等方面的差异。结果:PDT组的手术时间明显短于OT组,出血量明显少于OT组,切口大小明显小于OT组,差异均有统计学意义(P<0.05);PDT组的并发症发生率6.25%明显低于OT组的40.00%,差异有统计学意义(P<0.05)。结论:经皮扩张气管切开术具有术中及术后出血量少、创伤小、并发症少、手术操作过程简单、手术时间短等优点,适合于综合ICU的危重患者的应用,值得临床推广。

Objective：To explore the effect of percutaneous dilational tracheostomy（Percutaneous dilationaltracheostomy,PDT）in critically patients with artificial airway in ICU.Method：48 patients with PDT operation were selected from 2011 March to 2013 October in our department.And 45 cases with OT（Open tracheostomy）operation were selected as the control group during the same period.The differences in general condition and complication etc of two groups in intraoperative and postoperative were observed and compared.Result：Operation time of PDT group was significantly shorter than the OT group,the amount of bleeding was obviously less than the OT group,incision size was less than the OT group, the differences were statistically significant（P〈0.05）.The complication rate of PDT group was 6.25%,it was significantly lower than 40.00% of OT group,the difference was statistically significant（P〈0.05）.Conclusion：Percutaneous dilational tracheostomy has the advantages of the amount of less bleeding during and after operation,less trauma,less complications, simple operation process,short operation time,critically patients suitable for synthesis of ICU,is worth the clinical promotion.