纤维支气管镜直视下经皮微创气管切开术在重症监护室中的应用

Application of percutaneous tracheotomy under fiberoptic bronchoscope direct vision In ICU

目的评价纤维支气管镜直视下经皮微创气管切开术在重症监护室中的应用价值。方法选择70例需气管切开且无禁忌证的患者,随机分为纤维支气管镜直视下经皮微创气管切开术组(A组,30例)和传统开放式气管切开术组(B组,40例)。比较两组间手术时间,切口大小,出血量,安全性,血液、痰液窒息等并发症等方面的差异。结果 A组手术时间较B组明显缩短,切口小,出血量明显减少,安全性明显提高,其他并发症明显减少,差异均有统计学意义(P<0.05)。结论纤维支气管镜直视下经皮微创气管切开术具有操作简便,创伤小,安全性高,成功率高,并发症少等优势,在重症监护室中具有较大的应用价值。

Objective To find out the evaluation of the application of fiber bronchoscope direct vision in minimally invasive percutaneous traeheostomy in ICU. Methods To arrange 70 patients who will be required tracheotomy and all of them no contraindications, into two groups, one in bronchoseope under direct vision Percutaneous tracheostomy group of 30 patients, the other is traditional way, that is open tracheostomy group ,40 patients. Comparing differences between the two groups in the operative time, incision size, amount of bleeding, margin of safety, tracheoesophageal fistula,complications such as blood sputum asphyxia and others. Outcomes The operation time in former way is significantly shorter than then traditional open tracheostomy group, and with Incision significantly and the amount of bleeding reduced. Results The margin of safety also will be prompted. The diffences between the two were statistically significant（ P 〈 0. 05 ）. Conclusion Fiberoptic bronchoscope under direct vision Percutaneous traeheostomy is a simple, minimally invasive, safer and with a higher success rate. At the same time, the method has fewer complications. All the advantages prove that this is of great value in ICU.